Department of Pharmacy, Yamanashi Prefectural Central Hospital.
Education and Research Center for Clinical Pharmacy, Showa Pharmaceutical University.
Yakugaku Zasshi. 2024;144(6):685-690. doi: 10.1248/yakushi.23-00206.
Docetaxel (DTX) is a key drug used in perioperative chemotherapy for breast cancer. Edema is a known adverse effect of DTX, but its effect on health-related QOL (HRQOL) is unclear. In this study, we evaluated the effects of edema caused by administration of DTX on HRQOL in patients with early-stage breast cancer. We prospectively investigated patients diagnosed with early-stage breast cancer (stage I-III) who received 4 cycles of DTX as preoperative or postoperative chemotherapy between September 2021 and December 2022 at Yamanashi Prefectural Central Hospital. The circumference of each extremity was measured at each administration of DTX, and limb edema was evaluated by Common Terminology Criteria for Adverse Events version 5.0. HRQOL was evaluated using SF-12 version 2, which has a range of 0-100 (national standard, 50), and compared between the presence and absence of grade 2 or higher edema and between before and after administration of DTX. Twenty patients met the eligibility criteria and were included in the study. There was no difference in the HRQOL score according to whether grade 2 limb edema was present. The median HRQOL summary scores before and after administration of DTX were 51.1 and 50.8 (p=0.763), respectively, for mental health, 52.6 and 49.4 (p=0.005) for physical health, and 38.9 and 37.5 (p=1.000) for role/social health. We found no direct effect of DTX-induced limb edema on HRQOL in patients with early-stage breast cancer. However, HRQOL summary scores indicated that administration of DTX reduced physical health in these patients.
多西他赛(DTX)是乳腺癌围手术期化疗的关键药物。水肿是 DTX 的已知不良反应,但它对健康相关生活质量(HRQOL)的影响尚不清楚。在这项研究中,我们评估了 DTX 给药引起的水肿对早期乳腺癌患者 HRQOL 的影响。我们前瞻性调查了 2021 年 9 月至 2022 年 12 月在山梨县中央医院接受 4 个周期 DTX 术前或术后化疗的早期乳腺癌(I-III 期)患者。在每次给予 DTX 时测量四肢的周长,并使用不良事件通用术语标准 5.0 评估肢体水肿。使用 SF-12 版本 2 评估 HRQOL,范围为 0-100(国家标准,50),并比较 2 级或以上水肿的存在与不存在以及 DTX 给药前后的情况。20 名符合入选标准的患者被纳入研究。是否存在 2 级肢体水肿对 HRQOL 评分没有影响。DTX 给药前后的 HRQOL 综合评分分别为 51.1 和 50.8(p=0.763),心理健康为 52.6 和 49.4(p=0.005),身体健康为 38.9 和 37.5(p=1.000),社会健康。我们没有发现 DTX 引起的肢体水肿对早期乳腺癌患者 HRQOL 有直接影响。然而,HRQOL 综合评分表明,DTX 给药降低了这些患者的身体健康状况。