Chemotherapy dose per kilogram lean body mass increased dose-limiting toxicity event in male head and neck cancer with taxane and platinum-based induction therapy.
Chemotherapy dose per kilogram lean body mass increased dose-limiting toxicity event in male head and neck cancer with taxane and platinum-based induction therapy.
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DOI：
10.1186/s12885-022-10152-y
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发表时间：
2022-10-21
期刊：
影响因子：
3.8
通讯作者：
中科院分区：
文献类型：
--
作者：
本研究旨在确定每公斤瘦体重(LBM)的药物剂量是否与头颈癌(HNC)患者的剂量限制性毒性(DLT)事件相关。这项回顾性队列研究包括179名在2014年5月1日至2021年5月31日期间在医学中心接受诱导化疗(IC)的HNC患者。记录HNC患者的特征、肿瘤因素、IC方案和剂量、实验室资料以及CT、MRI或PET扫描图像得出的瘦体重(LBM)和骨骼肌指数(SMI)等身体成分因素，以及每公斤LBM的药物剂量。以剂量限制毒性(DLT)事件为主要结局。采用多因素Logistic回归分析，利用上述变量建立新的DLT事件危险评分。上述风险评分在另一个队列中得到验证。179例HNC患者在第一个IC周期发生DLT事件的总发生率为24%。按性别分层后，多西紫杉醇/kg LBM >； 2.52 mg/kg(调整后优势比：3.18；95%可信区间：1.2 5~8.0 9)、治疗前谷丙转氨酶 和GT； 40U/L(调整优势比，2.61；95%CI，1.0 3~6.6 4)和慢性肝病史(AOR，3.98；95%CI，1.0 3~15.46)是男性高血压病患者的显著危险因素。对男性HNC患者的上述危险因素进行汇总，对DLT事件风险进行分类。根据总事件的17.6%、25.8%和75%对三个风险组进行分层。上述风险得分在另一验证队列中具有可接受的区分能力。在接受IC治疗的男性HNC患者中，多西紫杉醇/kg LBM>2.52 mg/kg，治疗前谷丙转氨酶 和GT； 40U/L和慢性肝病史是发生DLT事件的显著危险因素。识别高危患者可以帮助医生预防接受IC的HNC患者的严重/致命并发症，特别是对男性患者。网上版载有补充材料，可在10.1186/s12885-022-10152-y查阅。
This study aimed to determine whether drug doses per kilogram of lean body mass (LBM) were associated with dose-limiting toxicity (DLT) events in head and neck cancer (HNC) patients. This retrospective cohort study included 179 HNC patients who underwent induction chemotherapy (IC) at a medical center from May 1, 2014, to May 31, 2021. HNC patients’ characteristics, tumor factors, IC regimen and dose, laboratory data, and body composition factors, including lean body mass (LBM) and skeletal muscle index (SMI), derived from CT, MRI, or PET scan images and drug dose per kilogram LBM were recorded. Dose-limiting toxicity (DLT) events were regarded as the primary outcome. Multivariate logistic regression was used to establish a novel risk score for DLT events by the abovementioned variables. The above-mentioned risk score was validated in another cohort. The overall DLT events during the first cycle of IC for 179 HNC patients was 24%. After stratifying by gender, docetaxel per kilogram LBM > 2.52 mg/kg (adjusted odds ratio [aOR]: 3.18; 95% confidence interval [CI], 1.25–8.09), pre-treatment glutamic pyruvic transaminase (GPT) > 40 U/L (aOR, 2.61; 95% CI, 1.03–6.64), and history of chronic liver diseases (aOR, 3.98; 95% CI, 1.03–15.46) were significant variables in male HNC patients. The DLT events risk was categorized by summation of the above-mentioned risk factors for male HNC patients. Three risk groups were stratified by overall event of 17.6%, 25.8%, and 75%. The above-mentioned risk score had an acceptable discriminatory ability in another validation cohort. Among male HNC patients treated with IC, docetaxel per kilogram LBM more than 2.52 mg/kg, pre-treatment GPT > 40 U/L, and history of chronic liver disease were significant risk factors for DLT events. Identifying high-risk patients could help physicians prevent severe/fatal complications among HNC patients undergoing IC, especially for the male individuals. The online version contains supplementary material available at 10.1186/s12885-022-10152-y.
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影响因子：
4.8
作者：
Swartz, Justin E.;Pothen, Ajit J.;Grolman, Wilko
通讯作者：
Grolman, Wilko
影响因子：
3.6
作者：
Sjoblom, Bjorg;Benth, Jurate Saltyte;Jordhoy, Marit
通讯作者：
Jordhoy, Marit
影响因子：
2.3
作者：
Mezi, Silvia;Pomati, Giulia;Marchetti, Paolo
通讯作者：
Marchetti, Paolo
影响因子：
4.6
作者：
Faron, Anton;Sprinkart, Alois M.;Luetkens, Julian A.
通讯作者：
Luetkens, Julian A.
DOI：
10.1002/onco.13822
发表时间：
2021-09
期刊：
The oncologist
影响因子：
--
作者：
Nielson CM;Bylsma LC;Fryzek JP;Saad HA;Crawford J
通讯作者：
Crawford J