Oxaliplatin-Free Interval as a Risk Factor for Hypersensitivity Reaction among Colorectal Cancer Patients Treated with FOLFOX
Oxaliplatin-Free Interval as a Risk Factor for Hypersensitivity Reaction among Colorectal Cancer Patients Treated with FOLFOX
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DOI：
10.1159/000320613
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发表时间：
2010-01-01
期刊：
影响因子：
3.5
通讯作者：
Fukushima, Masanori
中科院分区：
文献类型：
--
作者：
Mori, Yukiko;Nishimura, Takafumi;Fukushima, Masanori
背景：超敏反应（HSR）和感觉神经病变是奥沙利铂化疗的主要并发症。在前六个周期后预先计划停用奥沙利铂并在疾病进展时重新引入（停停策略）可以减少神经毒性。然而，奥沙利铂停药间隔对 HSR 发生的影响仍知之甚少。患者和方法：从京都大学医院门诊肿瘤科的前瞻性队列数据库中检索2005年6月至2009年6月期间接受FOLFOX（5-氟尿嘧啶、亚叶酸和奥沙利铂）治疗的结直肠癌患者的数据。进行因子分析。结果：接受 6 个或更少周期 FOLFOX 治疗的患者中，HSR 发生率较低（7/99，7.1%）。对于接受超过 6 个周期的患者，接受停走 FOLFOX 治疗的患者的 HSR 发生率高于接受连续 FOLFOX 治疗的患者（25/61, 41.0% vs. 13/63, 20.6%；p = 0.019）。有趣的是，大多数在走走停停的 FOLFOX 期间发生 HSR 的病例发生在重新引入阶段的第二个或第三个周期（21/25，84%）。多变量分析确定经历无奥沙利铂间隔是一个独立的危险因素（p = 0.016）。结论：奥沙利铂停药间隔可能会增加 HSR 风险。重新引入奥沙利铂后的第二个和第三个周期需要特别警惕。版权所有 (C) 2010 S. Karger AG，巴塞尔
Background: Hypersensitivity reaction (HSR) and sensory neuropathy are major complications of oxaliplatin-based chemotherapy. Preplanned withdrawal of oxaliplatin after the first six cycles and reintroduction at the time of disease progression (stop-and-go strategy) may reduce neurotoxicity. However, the effect of an oxaliplatin-free interval on HSR occurrence remains poorly understood. Patients and Methods: Data on patients with colorectal cancer who received FOLFOX (5-fluorouracil, leucovorin and oxaliplatin) treatment between June 2005 and June 2009 were retrieved from the prospective cohort database of the Outpatient Oncology Unit of the Kyoto University Hospital. Factor analysis was performed. Results: Among patients who received six or fewer cycles of FOLFOX, the incidence of HSR was low (7/99, 7.1%). For patients who received more than six cycles, the incidence of HSR was higher among patients treated with stop-and-go FOLFOX than among patients treated with continuous FOLFOX (25/61, 41.0% vs. 13/63, 20.6%; p = 0.019). Interestingly, most cases of HSR during stop-and-go FOLFOX occurred during the second or third cycle of the reintroduction phase (21/25, 84%). Multivariate analysis identified undergoing an oxaliplatin-free interval as an independent risk factor (p = 0.016). Conclusions: An oxaliplatin-free interval may increase the risk of HSR. Special vigilance is needed during the second and third cycles after reintroduction of oxaliplatin. Copyright (C) 2010 S. Karger AG, Basel