内容紹介
The Safety of Super-Selective Intra-Arterial Infusion Chemotherapy for Induction with Docetaxel, Cisplatin, and 5-Fluorouracil for Oral Cancer
Summary
Adverse events and complications were retrospectively evaluated in 13 oral cancer patients receiving 3-drug, super-selective, intra-arterial infusion induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil(Group A), and another 13 patients receiving systemic chemotherapy(Group B). As a systemic adverse event, neutropenia was significantly milder in Group A than in Group B(p=0.043). However, among local adverse events, the incidence rates of oral mucous membrane disorders were 69.2%(9 patients)in Group A and 23.1%(3 patients)in Group B, and therefore significantly higher in Group A(p=0.021). No significant difference was observed between the two groups considering the time of onset of oral mucous membrane disorders. Among complications, there were no cerebral infarctions, but facial palsy occurred in 1 patient. Thus, in a comparison between adverse events associated with super-selective intra-arterial infusion induction chemotherapy for oral cancer and systemic chemotherapy, the former showed milder neutropenia and a trend toward milder systemic adverse events. However, the incidence rate of oral mucositis as a local adverse event was significantly higher. For super-selective intra-arterial infusion chemotherapy, it appears to be important to prevent oral mucositis and to control the risks of complications such as facial palsy and cerebral infarction.
要旨
口腔癌に対して導入化学療法としてdocetaxel,cisplatin,5-fluorouracilの3剤併用による超選択的動注化学療法を施行した13例(A群)と全身化学療法を施行した13例(B群)の有害事象および合併症をレトロスペクティブに検討を行った。全身性有害事象としては,血液毒性では好中球減少でA群はB群と比較して有意に軽度であった(p=0.043)。しかし,局所性有害事象として口腔粘膜障害の発現率はA群9例(69.2%),B群3例(23.1%)であり,A群において有意に高かった(p=0.021)。口腔粘膜障害の発現時期は両群間には有意な差は認められなかった。また,合併症として脳梗塞は認められなかったが,顔面神経麻痺が1例に発症した。
以上より,口腔癌の導入化学療法として超選択的動注化学療法は有害事象について全身化学療法と比較して好中球減少に関しては軽度であり,全身性有害事象は軽度な傾向がある。しかし,局所性有害事象として口腔粘膜炎の頻度が有意に高く予防が重要であり,合併症である顔面神経麻痺や脳梗塞のリスクを管理することが重要であると考えられる。
目次
Summary
Adverse events and complications were retrospectively evaluated in 13 oral cancer patients receiving 3-drug, super-selective, intra-arterial infusion induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil(Group A), and another 13 patients receiving systemic chemotherapy(Group B). As a systemic adverse event, neutropenia was significantly milder in Group A than in Group B(p=0.043). However, among local adverse events, the incidence rates of oral mucous membrane disorders were 69.2%(9 patients)in Group A and 23.1%(3 patients)in Group B, and therefore significantly higher in Group A(p=0.021). No significant difference was observed between the two groups considering the time of onset of oral mucous membrane disorders. Among complications, there were no cerebral infarctions, but facial palsy occurred in 1 patient. Thus, in a comparison between adverse events associated with super-selective intra-arterial infusion induction chemotherapy for oral cancer and systemic chemotherapy, the former showed milder neutropenia and a trend toward milder systemic adverse events. However, the incidence rate of oral mucositis as a local adverse event was significantly higher. For super-selective intra-arterial infusion chemotherapy, it appears to be important to prevent oral mucositis and to control the risks of complications such as facial palsy and cerebral infarction.
要旨
口腔癌に対して導入化学療法としてdocetaxel,cisplatin,5-fluorouracilの3剤併用による超選択的動注化学療法を施行した13例(A群)と全身化学療法を施行した13例(B群)の有害事象および合併症をレトロスペクティブに検討を行った。全身性有害事象としては,血液毒性では好中球減少でA群はB群と比較して有意に軽度であった(p=0.043)。しかし,局所性有害事象として口腔粘膜障害の発現率はA群9例(69.2%),B群3例(23.1%)であり,A群において有意に高かった(p=0.021)。口腔粘膜障害の発現時期は両群間には有意な差は認められなかった。また,合併症として脳梗塞は認められなかったが,顔面神経麻痺が1例に発症した。
以上より,口腔癌の導入化学療法として超選択的動注化学療法は有害事象について全身化学療法と比較して好中球減少に関しては軽度であり,全身性有害事象は軽度な傾向がある。しかし,局所性有害事象として口腔粘膜炎の頻度が有意に高く予防が重要であり,合併症である顔面神経麻痺や脳梗塞のリスクを管理することが重要であると考えられる。