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蒽环类药物-环磷酰胺方案与多西他赛单药治疗在口腔黏膜炎发生中的关系。

Relationship Between Anthracycline-cyclophosphamide Regimens and Docetaxel Monotherapy in Oral Mucositis Development.

作者信息

Saito Yoshitaka, Sakamoto Tatsuhiko, Takekuma Yoh, Takahashi Masato, Oshino Tomohiro, Sugawara Mitsuru

机构信息

Department of Clinical Pharmaceutics & Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan;

Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan.

出版信息

In Vivo. 2025 Jul-Aug;39(4):2259-2266. doi: 10.21873/invivo.14021.

Abstract

BACKGROUND/AIM: We have previously reported that patients experiencing oral mucositis (OM) during anthracycline-cyclophosphamide treatment develop symptoms following subsequent docetaxel-containing chemotherapy for perioperative breast cancer therapy. However, the concomitant use of pertuzumab and trastuzumab with docetaxel has also been suggested as a significant risk factor for OM. This study aimed to further evaluate the direct relationship of OM with anthracycline-cyclophosphamide treatment and docetaxel monotherapy.

PATIENTS AND METHODS

Patients with breast cancer who underwent anthracycline-cyclophosphamide treatment followed by docetaxel monotherapy as perioperative therapy (n=63) were divided into control and OM-experience groups based on the absence or presence of OM development during prior anthracycline-cyclophosphamide treatment, and retrospectively evaluated. The primary endpoint was the comparison of all-grade OM incidence in the first docetaxel cycle between the two groups. The incidence of OM and dysgeusia was also assessed across all treatment cycles.

RESULTS

The incidence of all-grade OM was 42.9% in the OM-experience group and 9.5% in the control group during the first cycle (=0.006) and 47.6% and 11.9% across all treatment cycles (=0.004), thereby achieving the primary endpoint. In contrast, the incidence of grade ≥2 OM in both settings was higher in the OM-experience group than in the control group, although the difference was not statistically significant (14.3% . 2.4%, =0.10 for both settings). Moreover, the incidence of dysgeusia did not differ between the two groups.

CONCLUSION

Patients exhibiting OM during prior anthracycline-cyclophosphamide treatment were significantly more likely to develop symptoms during subsequent docetaxel monotherapy for perioperative breast cancer therapy.

摘要

背景/目的:我们之前曾报道,在蒽环类药物-环磷酰胺治疗期间出现口腔黏膜炎(OM)的患者,在随后接受含多西他赛的围手术期乳腺癌化疗时会出现症状。然而,同时使用帕妥珠单抗和曲妥珠单抗与多西他赛也被认为是发生OM的一个重要危险因素。本研究旨在进一步评估OM与蒽环类药物-环磷酰胺治疗及多西他赛单药治疗之间的直接关系。

患者与方法

将接受蒽环类药物-环磷酰胺治疗后再接受多西他赛单药围手术期治疗的乳腺癌患者(n = 63),根据之前蒽环类药物-环磷酰胺治疗期间是否发生OM,分为对照组和OM经历组,并进行回顾性评估。主要终点是比较两组在首个多西他赛周期中所有级别的OM发生率。还评估了所有治疗周期中OM和味觉障碍的发生率。

结果

在首个周期中,OM经历组所有级别的OM发生率为42.9%,对照组为9.5%(P = 0.006),在所有治疗周期中分别为47.6%和11.9%(P = 0.004),从而达到了主要终点。相比之下,在两种情况下,OM经历组≥2级OM的发生率均高于对照组,尽管差异无统计学意义(两种情况均为14.3%对2.4%,P = 0.10)。此外,两组之间味觉障碍的发生率没有差异。

结论

在之前蒽环类药物-环磷酰胺治疗期间出现OM的患者,在随后接受围手术期乳腺癌多西他赛单药治疗时出现症状的可能性显著更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/898e/12223616/1ee1f90aadc1/in_vivo-39-2262-g0001.jpg

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