Department of Digestive and Transplant Surgery, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 7708503, Japan.
Int J Clin Oncol. 2022 Sep;27(9):1439-1449. doi: 10.1007/s10147-022-02199-5. Epub 2022 Jul 30.
This study was performed to assess the impact of osteopenia on chemotherapy-induced neutropenia and the prognosis for patients treated with FOLFOXIRI for colorectal cancer.
In total, 77 patients who underwent FOLFOXIRI for un-resectable metastatic and advanced colorectal cancer were retrospectively evaluated. Osteopenia was evaluated by the bone mineral density, which was measured using the average pixel density of the trabecular bone in the 11th thoracic vertebra by computed tomography before the introduction of chemotherapy. The relationship between osteopenia and neutropenia was evaluated. Progression-free survival and overall survival of patients with osteopenia and patients with neutropenia were evaluated.
Grade ≥ 3 neutropenia was significantly more common in patients with than without osteopenia (p = 0.002). The multivariate analysis showed that osteopenia was a significant independent predictive factor for grade ≥ 3 neutropenia (p = 0.016). There was no significant difference in progression-free survival or overall survival between patients with and without osteopenia. Patients with grade ≥ 3 neutropenia tended to have a higher progression-free survival rate than others (p = 0.059). The overall survival rate was significantly higher in patients with grade ≥ 3 neutropenia than in others (p = 0.011).
Osteopenia might be a predictor of chemotherapy-induced neutropenia, and neutropenia might be a prognostic factor for progression-free survival and overall survival in patients with colorectal cancer treated with FOLFOXIRI.
本研究旨在评估骨质疏松症对结直肠癌患者接受 FOLFOXIRI 化疗引起的中性粒细胞减少症的影响及其预后。
回顾性分析了 77 例接受不可切除的转移性和晚期结直肠癌 FOLFOXIRI 治疗的患者。骨质疏松症通过骨密度评估，在开始化疗前通过 CT 测量第 11 胸椎的小梁骨的平均像素密度来评估。评估骨质疏松症与中性粒细胞减少症之间的关系。评估骨质疏松症和中性粒细胞减少症患者的无进展生存期和总生存期。
骨质减少症患者的 3 级及以上中性粒细胞减少症发生率明显高于无骨质减少症患者（p=0.002）。多因素分析显示，骨质减少症是 3 级及以上中性粒细胞减少症的独立预测因素（p=0.016）。骨质减少症患者与无骨质减少症患者的无进展生存期或总生存期无显著差异。3 级及以上中性粒细胞减少症患者的无进展生存率较高（p=0.059）。3 级及以上中性粒细胞减少症患者的总生存率明显高于其他患者（p=0.011）。
骨质疏松症可能是化疗引起的中性粒细胞减少症的预测因子，中性粒细胞减少症可能是接受 FOLFOXIRI 治疗的结直肠癌患者无进展生存期和总生存期的预后因素。
