Serum selenium predicts achievement of full-dose cisplatin in concurrent chemoradiotherapy for locally advanced head and neck squamous cell carcinoma: A prospective, observational study
Serum selenium predicts achievement of full-dose cisplatin in concurrent chemoradiotherapy for locally advanced head and neck squamous cell carcinoma: A prospective, observational study
复制标题
DOI：
10.1016/j.oraloncology.2021.105475
复制
发表时间：
2021-08-04
期刊：
影响因子：
4.8
通讯作者：
Katori，Yukio
中科院分区：
文献类型：
--
作者：
Ohkoshi，Akira;Ishii，Ryo;Katori，Yukio
目的三周高剂量顺铂（100mg /m2）同步放化疗（CCRT）是局部晚期头颈部鳞状细胞癌（HNSCC）的标准治疗方法，但由于各种不良事件，顺铂的依从性往往较差。这项前瞻性观察性研究的目的是确定实现全剂量顺铂的预测因素。方法对60例局部晚期HNSCC患者进行了一项前瞻性观察性研究，这些患者接受CCRT联合3周高剂量顺铂（100mg /m2）治疗。影响顺铂依从性的可能预测因素进行单因素和多因素logistic回归分析。年龄、性别、原发部位、临床分期、治疗意向、高血压史、糖尿病、吸烟和饮酒习惯、体重指数、肌酐清除率、血清白蛋白、控制营养状况、微量元素（铁、锌、铜、硒）、急性肾损伤、白细胞计数减少、中性粒细胞增多和体重减轻是评估的变量。结果27例患者获得全剂量顺铂治疗（300mg /m2）， 33例患者未获得全剂量顺铂治疗。多因素logistic回归分析显示，单独治疗前轻度肾功能不全和硒缺乏均对顺铂全剂量的实现有负面影响。结论硒缺乏与肾功能一样，是高剂量顺铂联合CCRT治疗HNSCC患者的潜在治疗靶点。
ObjectiveConcurrent chemoradiotherapy (CCRT) with three-weekly high-dose cisplatin (100 mg/m2) is a standard treatment for locally advanced head and neck squamous cell carcinoma (HNSCC), but compliance with cisplatin is often poor due to various adverse events. The aim of this prospective, observational study was to determine the predictors of achievement of full-dose cisplatin.MethodsA prospective, observational study was conducted involving 60 patients who received CCRT with three-weekly high-dose cisplatin (100 mg/m2) for locally advanced HNSCC. Possible predictors affecting compliance with cisplatin were subjected to univariate and multivariate logistic regression analyses. Age, sex, primary site, clinical stage, treatment intent, history of hypertension, diabetes mellitus, smoking and drinking habits, body mass index, creatinine clearance, serum albumin, controlling nutrition status, trace elements (Fe, Zn, Cu, Se), acute kidney injury, white blood cell count decrease, neutrophilia, and weight loss were the variables evaluated.ResultsTwenty-seven patients achieved full-dose cisplatin (300 mg/m2), and the other 33 patients did not. Multivariate logistic regression analysis showed that both mild renal dysfunction and selenium deficiency before treatment independently had negative impacts on achievement of full-dose cisplatin.ConclusionsAs well as renal function, selenium deficiency is a potential therapeutic target for CCRT with high-dose cisplatin in HNSCC patients.