Comparing the efficacy of a triplet antiemetic regimen in patients with esophageal cancer patients and diabetes mellitus treated with cisplatin-based chemotherapy: A retrospective study.

IF 2.5 3区 医学 Q3 ONCOLOGY Oncology Pub Date : 2024-12-07 DOI:10.1159/000543026
Masahiro Hatori, Shota Fukuoka, Shunya Kimura, Kazuyoshi Kawakami, Kensei Yamaguchi, Masakazu Yamaguchi
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引用次数: 0

Abstract

Introduction: Cisplatin-based highly emetogenic chemotherapy is recommended in combination with neurokinin-1 receptor antagonist (NK1RA), 5-hydroxytriptamine-3-receptor antagonist (5HT3RA), dexamethasone (DEX), and olanzapine. However, olanzapine is contraindicated in patients with pre-existing diabetes mellitus (DM). This study compared the efficacy of a triplet antiemetic regimen (NK1RA, 5HT3RA, and DEX) in patients with and without pre-existing DM treated with cisplatin-based chemotherapy.

Methods: This retrospective study enrolled patients with esophageal cancer with and without pre-existing DM who received fluorouracil and cisplatin (FP) combination chemotherapy as initial therapy with a triplet antiemetic regimen for antiemetic prophylaxis. This data was compared using propensity score matching (PSM). The primary endpoint was the complete response (CR) rate during the first cycle, which was defined as no emetic episodes and no rescue medication use during the overall period (0-120 h). The CR rate was analyzed using univariate and multivariate logistic regression, including previously reported risk factors. The significance level was set at 5%.

Results: Out of 210 eligible patients, 39 and 39 were patients with DM and non-DM patients after PSM, respectively. The CR rate measured by multivariate analysis during the overall period with DM and non-DM was 56.4% and 41.0% (adjusted odds ratio of 0.566 [95% confidence intervals: 0.209-1.536], P = 0.264), respectively. The CR rate during the delayed period (24-120 h) with DM and non-DM patients was 84.6% and 46.2% (P = 0.002), respectively.

Conclusions: A triplet antiemetic regimen in patients with esophageal cancer with pre-existing DM might be more effective in delayed period compared to non-DM patients.

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简介:以顺铂为基础的高致呕吐化疗建议与神经激肽-1受体拮抗剂(NK1RA)、5-羟色胺-3-受体拮抗剂(5HT3RA)、地塞米松(DEX)和奥氮平联合使用。然而,奥氮平禁用于已有糖尿病(DM)的患者。本研究比较了三联止吐方案(NK1RA、5HT3RA和DEX)在接受顺铂化疗的糖尿病患者和非糖尿病患者中的疗效:这项回顾性研究纳入了接受氟尿嘧啶和顺铂(FP)联合化疗作为初始治疗并使用三联止吐方案进行止吐预防的食管癌患者,这些患者中既有DM患者,也有未曾患有DM的患者。这些数据采用倾向得分匹配法(PSM)进行比较。主要终点是第一周期的完全应答率(CR),其定义是在整个周期(0-120 h)内无呕吐发作且未使用抢救药物。完全应答率采用单变量和多变量逻辑回归进行分析,其中包括之前报道的风险因素。显著性水平设定为 5%:在 210 名符合条件的患者中,分别有 39 名和 39 名在 PSM 后患有 DM 和非 DM。通过多变量分析测得,DM和非DM患者总体期间的CR率分别为56.4%和41.0%(调整后的几率比为0.566[95%置信区间:0.209-1.536],P=0.264)。DM和非DM患者在延迟期(24-120小时)的CR率分别为84.6%和46.2%(P = 0.002):结论:对于已有DM的食管癌患者,三联止吐方案在延迟期可能比非DM患者更有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Oncology
Oncology 医学-肿瘤学
CiteScore
6.00
自引率
2.90%
发文量
76
审稿时长
6-12 weeks
期刊介绍: Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.
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