Saito Yoshitaka, Takekuma Yoh, Takahashi Masato, Oshino Tomohiro, Sugawara Mitsuru
Department of Clinical Pharmaceutics & Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, 4-1, Maeda 7-Jo 15-Chome, Teine-Ku, Sapporo, 006-8585, Japan.
Department of Pharmacy, Hokkaido University Hospital, Kita 14-Jo, Nishi 5-Chome, Kita-Ku, Sapporo, 060-8648, Japan.
Support Care Cancer. 2024 Jul 13;32(8):513. doi: 10.1007/s00520-024-08733-7.
Anthracycline-cyclophosphamide followed by docetaxel-containing chemotherapy is effective for perioperative breast cancer treatment. However, these treatments frequently induce oral mucositis (OM), with an incidence ranging from 20 to 50%. The association of OM development between different chemotherapeutic treatments remains unclear. Consequently, this study aimed to compare OM development during docetaxel-containing chemotherapy between patients with and without OM experience during previous anthracycline-cyclophosphamide treatments to assess the association between OM development and treatment regimens.
Seventy-two patients with breast cancer receiving anthracycline-cyclophosphamide followed by docetaxel-containing chemotherapy as a perioperative treatment were categorized into the control (no prior OM experience with anthracycline-cyclophosphamide) and OM-experience (OM development during previous treatment) groups and retrospectively evaluated. The primary endpoint was the incidence of all-grade OM in the first docetaxel-containing chemotherapy cycle. Additionally, the incidences of OM and dysgeusia during all treatment cycles and factors associated with the incidence of OM were evaluated.
The incidence of all-grade OM in the first cycle was significantly higher in the OM-experience group (54.2%) than in the control group (10.4%; P < 0.0001). Furthermore, its incidence in all treatment cycles was higher in the OM-experience group (66.7%) than in the control group (12.5%, P < 0.0001). However, the incidence of dysgeusia did not differ between the groups. Multivariate logistic regression analysis revealed OM experience during previous anthracycline-cyclophosphamide treatment and concomitant pertuzumab use as independent risk factors for OM development in subsequent docetaxel-containing chemotherapy.
Our study suggests that patients experiencing OM with anthracycline-cyclophosphamide during perioperative breast cancer treatment exhibit symptoms following subsequent docetaxel-containing chemotherapy.
蒽环类药物联合环磷酰胺后序贯含多西他赛的化疗方案对围手术期乳腺癌治疗有效。然而，这些治疗常诱发口腔黏膜炎（OM），发生率为20%至50%。不同化疗方案之间OM发生的关联仍不明确。因此，本研究旨在比较在先前接受蒽环类药物联合环磷酰胺治疗时有或无OM经历的患者在含多西他赛化疗期间OM的发生情况，以评估OM发生与治疗方案之间的关联。
72例接受蒽环类药物联合环磷酰胺后序贯含多西他赛化疗作为围手术期治疗的乳腺癌患者被分为对照组（先前接受蒽环类药物联合环磷酰胺治疗时无OM经历）和OM经历组（先前治疗期间发生OM），并进行回顾性评估。主要终点是首个含多西他赛化疗周期中所有级别的OM发生率。此外，还评估了所有治疗周期中OM和味觉障碍的发生率以及与OM发生率相关的因素。
OM经历组首个周期中所有级别的OM发生率（54.2%）显著高于对照组（10.4%；P＜0.0001）。此外，OM经历组所有治疗周期中的发生率（66.7%）高于对照组（12.5%，P＜0.0001）。然而，两组之间味觉障碍的发生率没有差异。多因素逻辑回归分析显示，先前蒽环类药物联合环磷酰胺治疗期间的OM经历以及同时使用帕妥珠单抗是后续含多西他赛化疗中OM发生的独立危险因素。
我们的研究表明，围手术期乳腺癌治疗期间经历蒽环类药物联合环磷酰胺所致OM的患者在后续含多西他赛化疗后会出现症状。
