奥沙利铂为基础的方案在老年转移性结直肠癌患者一线化疗中的疗效和安全性。

Efficacy and Safety of Oxaliplatin-based Regimens as First-line Chemotherapy in Elderly Patients With Metastatic Colorectal Cancer.

机构信息

Department of Pharmaceutical Health Care and Science, School of Pharmacy, Aichi Gakuin University, Aichi, Japan.

Department of Pharmacy, Gifu University Hospital, Gifu, Japan.

出版信息

Anticancer Res. 2023 Nov;43(11):5099-5105. doi: 10.21873/anticanres.16710.

Abstract

BACKGROUND/AIM: Metastatic colorectal cancer (mCRC) is mainly a disease of the elderly. The aim of this retrospective study was to investigate the efficacy and safety of oxaliplatin-based regimens as first-line chemotherapy in elderly patients with mCRC.

PATIENTS AND METHODS

We recruited mCRC patients aged ≥75 years who were treated with oxaliplatin-based chemotherapy as first-line therapy from October 2011 to November 2020. Primary outcome was median progression-free survival (PFS) and incidence of adverse events, while secondary outcomes included overall survival (OS), relative dose intensity (RDI) and tumor response rate.

RESULTS

The study enrolled 41 patients with mCRC aged ≥75 years. Median PFS and OS were 9.3 months and 38.9 months, respectively. Median rate of starting dose per standard dose and median RDI of L-OHP were 94.6% [interquartile range (IQR)=80.0-100] and 52.4% (IQR=30.2-71.1), respectively. The most common adverse events of grade ≥3 were neutropenia (21.4%), high blood pressure (16.7%), and anorexia (14.3%).

CONCLUSION

Although the RDI of L-OHP drug was low, the PFS, OS, and incidence of adverse events were similar to previous reports of oxaliplatin-based regimens not limited to the elderly. Oxaliplatin-based regimens as first-line chemotherapy may be safely and effectively adapted to patients aged ≥75 years with mCRC by continuing chemotherapy with implementation of a reduction and discontinuation of anticancer drugs depending on adverse events.

摘要

背景/目的:转移性结直肠癌(mCRC)主要发生于老年人群。本回顾性研究旨在探讨奥沙利铂为基础的方案作为 mCRC 老年患者一线化疗的疗效和安全性。

患者与方法

我们招募了 2011 年 10 月至 2020 年 11 月期间接受奥沙利铂为基础的化疗作为一线治疗的年龄≥75 岁 mCRC 患者。主要终点为中位无进展生存期(PFS)和不良事件发生率,次要终点包括总生存期(OS)、相对剂量强度(RDI)和肿瘤缓解率。

结果

该研究纳入了 41 例年龄≥75 岁的 mCRC 患者。中位 PFS 和 OS 分别为 9.3 个月和 38.9 个月。奥沙利铂标准剂量起始率和 L-OHP 的中位 RDI 分别为 94.6%(四分位距[IQR]=80.0-100)和 52.4%(IQR=30.2-71.1)。≥3 级不良事件中最常见的是中性粒细胞减少(21.4%)、高血压(16.7%)和厌食(14.3%)。

结论

尽管 L-OHP 药物的 RDI 较低,但 PFS、OS 和不良事件的发生率与奥沙利铂为基础的方案(不限于老年患者)的既往报告相似。奥沙利铂为基础的方案作为一线化疗,通过根据不良事件减少和停止抗癌药物的使用,可以安全有效地适用于年龄≥75 岁的 mCRC 患者。

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