Efficacy and Safety of a Parenteral Nutrition Program for Patients with RAS Wild-Type Metastatic Colorectal Cancer Administered First-Line Cetuximab Plus Chemotherapy: A Propensity Score Matching Study

被引:1
作者
Chang, Yu-Tang [1 ,2 ]
Chen, Chou-Chen [3 ]
Chang, Shih-Ching [4 ]
Chang, Yu-Yao [5 ,6 ]
Lin, Bo-Wen [7 ]
Chen, Hong-Hwa [8 ]
Hsieh, Yao-Yu [9 ,10 ]
Hsu, Hung-Chih [11 ,12 ]
Hsieh, Meng-Che [13 ]
Kuan, Feng-Che [14 ]
Wu, Chih-Chien [15 ,16 ]
Lu, Wei-Chen [17 ]
Su, Yu-Li [18 ]
Liang, Yi-Hsin [19 ]
Chen, Joe-Bin [20 ]
Huang, Shuan-Yuan [5 ]
Huang, Ching-Wen [2 ,21 ]
Wang, Jaw-Yuan [2 ,21 ,22 ,23 ,24 ]
机构
[1] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Surg, Div Pediat Surg, Kaohsiung 80708, Taiwan
[2] Kaohsiung Med Univ, Coll Med, Fac Med, Dept Surg, Kaohsiung 80708, Taiwan
[3] Taichung Vet Gen Hosp, Dept Surg, Taichung 40705, Taiwan
[4] Vet Gen Hosp, Dept Surg, Div Colon & Rectal Surg, Taipei 11217, Taiwan
[5] Changhua Christian Hosp, Dept Colorectal Surg, Changhua 50006, Taiwan
[6] Natl Chung Hsing Univ, Coll Med, Dept Postbaccalaureate Med, Taichung 40227, Taiwan
[7] Natl Cheng Kung Univ Hosp, Dept Surg, Tainan 70457, Taiwan
[8] Chang Gung Mem Hosp, Dept Surg, Div Colon & Rectal Surg, Kaohsiung 83301, Taiwan
[9] Taipei Med Univ, Shuang Ho Hosp, Div Hematol & Oncol, New Taipei City 23561, Taiwan
[10] Taipei Med Univ, Coll Med, Sch Med, Div Hematol & Oncol,Dept Internal Med, Taipei 11031, Taiwan
[11] Chang Gung Mem Hosp Linkou, Dept Internal Med, Div Hematol Oncol, Taoyuan 33305, Taiwan
[12] Chang Gung Univ, Coll Med, Taoyuan 33305, Taiwan
[13] I Shou Univ, E Da Hosp, Dept Internal Med, Div Hematol Oncol, Kaohsiung 84001, Taiwan
[14] Chang Gung Mem Hosp, Dept Hematol & Oncol, Chiayi 61363, Taiwan
[15] Kaohsiung Vet Gen Hosp, Dept Surg, Div Colorectal Surg, Kaohsiung 81362, Taiwan
[16] Natl Yang Ming Chiao Tung Univ, Sch Med, Taipei 30010, Taiwan
[17] Natl Taiwan Univ Hosp, Dept Oncol, Yunlin Branch, Yunlin 64041, Taiwan
[18] Chang Gung Mem Hosp, Dept Internal Med, Div Hematol & Oncol, Kaohsiung 33305, Taiwan
[19] Natl Taiwan Univ Hosp, Dept Oncol, Taipei 10002, Taiwan
[20] Chung Shan Med Univ Hosp, Dept Surg, Taichung 40201, Taiwan
[21] Kaohsiung Med Univ Hosp, Dept Surg, Div Colorectal Surg, Kaohsiung 80756, Taiwan
[22] Kaohsiung Med Univ, Grad Inst Clin Med, Coll Med, Kaohsiung 80708, Taiwan
[23] Kaohsiung Med Univ, Ctr Canc Res, Kaohsiung 80708, Taiwan
[24] Minist Hlth & Welf, Pingtung Hosp, Pingtung 90054, Taiwan
关键词
cetuximab; RAS wild-type; metastatic colorectal cancer; supplementary home parenteral nutrition; HOME; COMPLICATIONS; BEVACIZUMAB; IRINOTECAN;
D O I
10.3390/nu15132971
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Malnutrition is a common problem in patients with metastatic colorectal cancer (mCRC) receiving targeted therapy plus chemotherapy, resulting in severe toxicity and decreased survival rates. This retrospective study employing propensity score matching (PSM) examined the efficacy and safety of a supplemental home parenteral nutrition (HPN) program for patients with RAS wild-type mCRC receiving cetuximab plus chemotherapy. This retrospective nationwide registry study included data from 14 medical centers/hospitals across Taiwan, and the data period ranged from November 2016 to December 2020. Patients with RAS wild-type mCRC receiving cetuximab plus chemotherapy as their first-line therapy were included and divided into HPN and non-HPN program groups. HPN was initiated based on patient-specific factors, such as baseline nutritional status, treatment-related toxicities, and comorbidities. Clinical outcomes were evaluated using response to therapy, duration of response (DoR), progression-free survival (PFS), and overall survival (OS). This study recruited 758 patients, of whom 110 and 648 were included in the HPN and non-HPN program groups, respectively. After 1:3 PSM, the data of 109 and 327 patients from the HPN and non-HPN program groups were analyzed, respectively. The HPN program group had a higher metastasectomy rate (33.9% vs. 20.2%, p = 0.005), and longer duration of treatment and DoR than the non-HPN program group (13.6 vs. 10.3 and 13.6 vs. 9.9 months, p = 0.001 and < 0.001, respectively). The HPN program group tended to have a longer median PFS (18.2 vs. 13.9 months, p = 0.102). Moreover, we noted a significant improvement in the median OS in the same group (53.4 vs. 34.6 months, p = 0.002). Supplemental HPN programs may be recommended for select patients with mCRC receiving targeted therapy plus chemotherapy to improve oncological outcomes.
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页数:13
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