The burdens of cancer therapy - Clinical and economic outcomes of chemotherapy-induced mucositis
The burdens of cancer therapy - Clinical and economic outcomes of chemotherapy-induced mucositis
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DOI：
10.1002/cncr.11671
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发表时间：
2003-10-01
期刊：
影响因子：
6.2
通讯作者：
Cantor, SB
中科院分区：
文献类型：
--
作者：
Elting, LS;Cooksley, C;Cantor, SB
背景。粘膜炎是实体瘤患者常见但研究较少的问题。作者研究了接受骨髓抑制化疗的口腔和胃肠道（GI）粘膜炎患者的临床和经济结果。回顾性随机抽样599例发生化疗诱导骨髓抑制的患者，随访其口腔或胃肠道粘膜炎的发展情况以及随后出血或感染的发展情况。出血和感染风险的多水平回归模型与患者化疗周期吻合。在1236个化疗周期中，有37%发生了黏膜炎。有胃肠道黏膜炎的周期出血发生率明显高于无胃肠道黏膜炎的周期（13% vs. 8%; P = 0.04）。有粘膜炎（尤其是胃肠道粘膜炎）的周期感染发作明显比没有粘膜炎的周期更常见（73% vs. 36%; P < 0.0001）。在无黏膜炎、口腔黏膜炎和胃肠道黏膜炎的周期中，平均住院时间分别为4天、6天和12天。在考虑骨髓抑制的深度和持续时间以及其他预测因素后，胃肠道粘膜炎与出血（优势比[OR]， 2.0; P = 0.01）和感染（优势比[OR]， 2.24; P < 0.0001）相关，而口腔粘膜炎仅与感染相关（优势比[OR]， 2.4; P < 0.0001）。在接受骨髓抑制化疗的实体瘤患者中，粘膜炎具有临床和经济意义。需要新的预防和治疗药物。癌症2003;98:1531-9。(C) 2003年美国癌症协会。
BACKGROUND. Mucositis is a common but poorly studied problem among patients with solid tumors. The authors examined the clinical and economic outcomes of oral and gastrointestinal (GI) mucositis among patients receiving myelosuppressive chemotherapy.METHODS. A retrospective, random sample of 599 patients who developed chemotherapy-induced myelosuppression was followed for development of oral or GI mucositis and for development of subsequent episodes of bleeding or infection. Multilevel regression models of the risk of bleeding and infection were fit with chemotherapy cycles nested within patients.RESULTS. Mucositis developed during 37% of 1236 cycles of chemotherapy. Episodes of bleeding were significantly more common during cycles with GI mucositis than during cycles without GI mucositis (13% vs. 8%; P = 0.04). Episodes of infection were significantly more common during cycles with mucositis (especially GI mucositis) than during cycles without mucositis (73% vs. 36%; P < 0.0001). The mean durations of hospitalization were 4 days, 6 days, and 12 days during cycles with no mucositis, oral mucositis, and GI mucositis, respectively. After accounting for the depth and duration of myelosuppression and for other predictive factors, GI mucositis was associated with both bleeding (odds ratio [OR], 2.0; P = 0.01) and infection (OR, 2.24; P < 0.0001), whereas oral mucositis was associated with infection only (OR, 2.4; P < 0.0001).CONCLUSIONS. Mucositis was clinically and economically significant among patients with solid tumors who were receiving myelosuppressive chemotherapy. New preventive and therapeutic agents are needed. Cancer 2003;98:1531-9. (C) 2003 American Cancer Society.