Khan Mansoor, Alharbi Sara, Aljuhani Shahad, Tunkar Mariam, Morya Amjaad, Alnatsheh Abdelmajid, Alshamrani Majed, Felemban Razaz
Pharmaceutical Care Services, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, Jeddah, SAU.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU.
Cureus. 2023 Aug 28;15(8):e44267. doi: 10.7759/cureus.44267. eCollection 2023 Aug.
Background Fluoropyrimidine-based regimens are used for the management of colorectal cancer, which is the second most common cancer in Saudi Arabia. We aimed to study the incidence of hematological toxicities in colorectal cancer patients treated with fluoropyrimidine and fluoropyrimidine-based regimens at Princess Noorah Oncology Center, King Abdulaziz Medical City- Jeddah, Saudi Arabia. Methods A retrospective cohort study that included adult colorectal cancer patients who were treated with fluoropyrimidine-based regimens from January 1, 2018 to December 31, 2018 at Princess Noorah Oncology Center, Jeddah, Saudi Arabia was performed. Our primary objective was to determine the incidence of anemia, neutropenia, and thrombocytopenia in colorectal cancer patients treated with fluoropyrimidines and fluoropyrimidine-based regimens. Secondary objectives were to assess the grade of hematological toxicities associated with 5-fluorouracil (5-FU) use and to determine the frequency of unplanned hospital admissions or emergency department (ED) visits after receiving fluoropyrimidine-based regimens. The collected data contained patients' characteristics (weight, height, age, gender, and diagnosis), chemotherapy agents, and hematological toxicity-related findings such as absolute neutrophil count, hemoglobin, platelet count, and number of ED visits or hospital admissions during fluoropyrimidine-based chemotherapy regimens. Results Of the 570 cycles of the fluoropyrimidine-based regimen received by 68 patients, hematological toxicities were observed in 508 (89.1%) cycles, and grade ≥ 3 grade toxicities were found in 46 (8.1%) cycles. The results demonstrated a statistically significant difference in the incidence of grade 3-4 neutropenia between patients who received bolus administration of 5-FU and those who did not (8.5% vs. 2.3% respectively, p=0.025). The incidence of grade 3-4 anemia was higher in the bolus group (11.3%) compared to the group where bolus was omitted (4.6%); however, the difference was not statistically significant (p=0.059). Furthermore, there was no significant difference among the two groups for grade 3 and grade 4 thrombocytopenia (0.0% with bolus given and 0.7% with bolus omission p=1.00). Conclusion Our retrospective study showed that there have been significantly higher grade 3-4 hematological toxicities observed with bolus administration of 5-FU, which confirms the previous reports.
基于氟尿嘧啶的治疗方案用于结直肠癌的管理，结直肠癌是沙特阿拉伯第二常见的癌症。我们旨在研究沙特阿拉伯吉达阿卜杜勒阿齐兹国王医疗城努拉公主肿瘤中心接受氟尿嘧啶及基于氟尿嘧啶治疗方案的结直肠癌患者血液学毒性的发生率。
进行了一项回顾性队列研究，纳入了2018年1月1日至2018年12月31日在沙特阿拉伯吉达努拉公主肿瘤中心接受基于氟尿嘧啶治疗方案的成年结直肠癌患者。我们的主要目标是确定接受氟尿嘧啶及基于氟尿嘧啶治疗方案的结直肠癌患者贫血、中性粒细胞减少和血小板减少的发生率。次要目标是评估与使用5-氟尿嘧啶（5-FU）相关的血液学毒性等级，并确定接受基于氟尿嘧啶治疗方案后计划外住院或急诊就诊的频率。收集的数据包括患者特征（体重、身高、年龄、性别和诊断）、化疗药物以及与血液学毒性相关的结果，如绝对中性粒细胞计数、血红蛋白、血小板计数以及基于氟尿嘧啶化疗方案期间的急诊就诊或住院次数。
68例患者接受了570个周期的基于氟尿嘧啶的治疗方案，其中508个周期（89.1%）观察到血液学毒性，46个周期（8.1%）发现≥3级毒性。结果显示，接受5-FU推注的患者与未接受推注的患者相比，3-4级中性粒细胞减少的发生率存在统计学显著差异（分别为8.5%和2.3%，p=0.025）。推注组3-4级贫血的发生率（11.3%）高于未进行推注的组（4.6%）；然而，差异无统计学意义（p=0.059）。此外，两组在3级和4级血小板减少方面无显著差异（推注组为0.0%，未推注组为0.7%，p=1.00）。
我们的回顾性研究表明，5-FU推注观察到的3-4级血液学毒性显著更高，这证实了先前的报道。
