Department of Pharmacy, Hokkaido University Hospital, Kita 14-jo, Nishi 5-chome, Kita-ku, Sapporo, 060-8648, Japan.
Department of Breast Surgery, Hokkaido University Hospital, Kita 14-jo, Nishi 5-chome, Kita-ku, Sapporo, 060-8648, Japan.
Sci Rep. 2022 Jul 22;12(1):12587. doi: 10.1038/s41598-022-16935-4.
Oral mucositis (OM) is one of the most common complications associated with chemotherapy. Here, we evaluated whether systemic dexamethasone (DEX) dosage in prophylactic antiemetics affected the incidence of OM in anthracycline-containing regimens. Patients receiving anthracycline-containing regimens for breast cancer were divided into high- and low-DEX dose groups and retrospectively evaluated. The incidence of all-grade OM in the first cycle in the high- and low-dose groups was 27.3% and 53.5%, respectively, and was significantly lowered by increasing the DEX dose (P < 0.01); thus, the study met its primary endpoint. The result in all treatment cycles was also significant (P = 0.02). In contrast, the incidence of dysgeusia was similar between the high- and low-dose groups in the first and all cycles (13.6% and 16.3% in the first cycle [P = 0.79] and 27.3% and 34.9% in all cycles [P = 0.42], respectively). Multivariate analysis revealed that low DEX dosage was an independent risk factor for all-grade OM development. In conclusion, our study suggests that DEX attenuates OM in anthracycline-containing regimens for breast cancer treatment in a dose-dependent manner. Further evaluation of OM prophylaxis, including DEX administration, is required for better control.
口腔黏膜炎（OM）是与化疗相关的最常见并发症之一。在这里，我们评估了预防性止吐药物中全身地塞米松（DEX）剂量是否会影响含蒽环类药物方案中 OM 的发生率。接受含蒽环类药物方案治疗乳腺癌的患者被分为高和低 DEX 剂量组，并进行回顾性评估。高和低剂量组第一周期所有级别 OM 的发生率分别为 27.3%和 53.5%，DEX 剂量增加可显著降低 OM 发生率（P<0.01）；因此，该研究达到了其主要终点。所有治疗周期的结果也具有统计学意义（P=0.02）。相比之下，高和低剂量组在第一和所有周期的味觉障碍发生率相似（第一周期分别为 13.6%和 16.3%[P=0.79]，所有周期分别为 27.3%和 34.9%[P=0.42]）。多变量分析表明，DEX 低剂量是所有级别 OM 发展的独立危险因素。总之，我们的研究表明，DEX 以剂量依赖的方式减轻了含蒽环类药物方案治疗乳腺癌中的 OM。需要进一步评估 OM 的预防措施，包括 DEX 给药，以更好地控制 OM。
