低治疗前骨骼肌指数与接受多西他赛+顺铂+5-氟尿嘧啶（DCF）治疗的食管癌患者发生发热性中性粒细胞减少症的风险增加相关。
Low pretherapy skeletal muscle mass index is associated with an increased risk of febrile neutropenia in patients with esophageal cancer receiving docetaxel + cisplatin + 5-fluorouracil (DCF) therapy.
机构信息
Department of Pharmacy, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
The Education Center for Clinical Pharmacy, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan.
出版信息
Support Care Cancer. 2023 Feb 4;31(2):150. doi: 10.1007/s00520-023-07609-6.
PURPOSE
Docetaxel + cisplatin + 5-fluorouracil (DCF) therapy, a frequently prescribed regimen for esophageal cancer, is associated with a high risk of febrile neutropenia (FN). This study investigated whether a low skeletal muscle mass index (SMI) is an independent risk factor for FN.
METHODS
This retrospective, observational study investigated the SMI of patients with esophageal cancer who received DCF therapy between March 2018 and July 2020. Based on the Asian sarcopenia criteria, patients were divided into two groups: high and low SMI (SMI of < 7.0 and 5.7 kg/m for males and females, respectively). The incidence of FN was then compared between the two groups.
RESULTS
Thirty-nine patients (20 and 19 in the high- and low-SMI groups, respectively) were included in this study. The incidence of FN was significantly higher in the low-SMI group (63.2% vs. 20.0%, P = 0.006). Univariable and multivariable logistic regression analyses revealed that a low SMI was an independent risk factor for FN (odds ratio, 7.178; 95% confidence interval, 1.272-40.507; P = 0.026). In addition, the frequency of dose reduction in DCF therapy was significantly higher in the low-SMI group (68.4% vs. 35.0%, P = 0.037).
CONCLUSION
Low SMI is an independent risk factor for FN in patients with esophageal cancer receiving DCF therapy.
目的
多西他赛+顺铂+5-氟尿嘧啶（DCF）疗法是食管癌的常用治疗方案，但与高热中性粒细胞减少症（FN）的风险较高相关。本研究旨在探讨低骨骼肌质量指数（SMI）是否为 FN 的独立危险因素。
方法
本回顾性观察性研究纳入了 2018 年 3 月至 2020 年 7 月期间接受 DCF 治疗的食管癌患者的 SMI。根据亚洲肌少症标准，患者被分为两组：高 SMI 组（SMI>7.0kg/m2 男性和>5.7kg/m2 女性）和低 SMI 组（SMI<7.0kg/m2 男性和<5.7kg/m2 女性）。比较两组 FN 的发生率。
结果
本研究共纳入 39 例患者（高 SMI 组 20 例，低 SMI 组 19 例）。低 SMI 组 FN 的发生率明显较高（63.2% vs. 20.0%，P=0.006）。单变量和多变量逻辑回归分析显示，低 SMI 是 FN 的独立危险因素（优势比，7.178；95%置信区间，1.272-40.507；P=0.026）。此外，低 SMI 组 DCF 治疗剂量减少的频率明显更高（68.4% vs. 35.0%，P=0.037）。
结论
低 SMI 是食管癌患者接受 DCF 治疗后 FN 的独立危险因素。
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