吉西他滨-卡铂治疗非小细胞肺癌的毒性和依从性

D. Gómez Herrero , A. Albert Marí , M. Merino Sanjuán , M.L. Boquera Ferrer , N. Víctor Jiménez Torres
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引用次数: 2

摘要

目的分析吉西他滨-卡铂(GEM-CARBO)给药剂量与非小细胞肺癌患者血流变学和肾毒性发生率、水平及治疗依从性的关系。方法回顾性研究,为期37个月。在Farmis-Oncofarm®软件和医疗和药物治疗记录的帮助下,我们能够获得进行随访所需的最小数据集。血液学毒性按照通用毒性标准3.0进行评估。采用血清肌酐水平和肌酐清除率评估肾毒性。结果31例患者共接受122个周期的治疗。贫血和3级中性粒细胞减少的发生率分别为34.0%和30.8%。3级和4级血小板减少症的发生率分别为3.8%和7.7%。未发现肾毒性病例。65.0%的患者接受卡铂计划理论剂量超过85.0%,58%的患者接受吉西他滨计划理论剂量超过85.0%。在规定的周期中,有18.0%的给药延迟。结论GEM-CARBO方案的适应症和处方根据可靠的科学证据进行了调整,但其血液学毒性限制了其使用,使其难以维持研究预期的剂量强度。这损害了治疗的效果。
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Toxicity Profile and Adherence to the Pharmacotherapeutic Regimen of Gemcitabine–carboplatin in Non-small Cell Lung Cancer

Objective

To analyse the relationship between doses of gemcitabine–carboplatin (GEM-CARBO) administered and incidence and level of haematological and renal toxicity, and the adherence to the treatment in patients with non-small cell lung cancer.

Methods

Retrospective study, which lasted for 37 months. We were able to obtain the minimum set of data needed to carry out the follow-up with the help of Farmis-Oncofarm® software and the medical and pharmacotherapeutic records.

The haematological toxicity was assessed in accordance with the Common Toxicity Criteria 3.0. Renal toxicity was evaluated using serum creatinine levels and creatinine clearance.

Results

Thirty-one patients were included in the study who were administered a total of 122 cycles. There was a 34.0% and 30.8% incidence of anaemia and grade 3 neutropenia, respectively. There was also a 3.8% and 7.7% incidence of grade 3 and grade 4 thrombocytopenia, respectively. No cases of renal toxicity were found. 65.0% of patients received more than 85.0% of the planned theoretical dosage of carboplatin and 58% of patients received more than 85.0% of the planned theoretical dosage of gemcitabine. Administration was delayed in 18.0% of the cycles prescribed.

Conclusions

The indication and prescription of the GEM-CARBO regimen was adjusted in accordance with solid scientific evidence, but its haematological toxicity limited its use and made it difficult to maintain the dose intensity foreseen in the study. This compromised the effectiveness of the treatment.

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