Neutropaenia as a prognostic factor in metastatic colorectal cancer patients undergoing chemotherapy with first-line FOLFOX

被引:80
作者
Shitara, Kohei [1 ]
Matsuo, Keitaro [2 ]
Takahari, Daisuke [1 ]
Yokota, Tomoya [1 ]
Inaba, Yoshitaka [3 ]
Yamaura, Hidekazu [3 ]
Sato, Yozo [3 ]
Najima, Mina [3 ]
Ura, Takashi [1 ]
Muro, Kei [1 ]
机构
[1] Aichi Canc Ctr Hosp, Dept Clin Oncol, Chikusa Ku, Aichi 4648681, Japan
[2] Aichi Canc Ctr, Res Inst, Div Epidemiol & Prevent, Aichi, Japan
[3] Aichi Canc Ctr Hosp, Dept Diagnost & Intervent Radiol, Aichi 4648681, Japan
关键词
Colorectal cancer; Chemotherapy; FOLFOX; Neutropaenia; Prognostic factor; EFFICACY; FLUOROURACIL; OXALIPLATIN; LEUCOVORIN;
D O I
10.1016/j.ejca.2009.01.019
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
We retrospectively analysed 153 patients with metastatic colorectal cancer who received FOLFOX with or without bevacizumab as first-line chemotherapy. Several background characteristics and chemotherapy features (grade of neutropaenia, use of bevacizumab or irinotecan, re-introduction of FOLFOX, and tumour progression) as time-varying covariates were analysed as potential prognostic factors. Of the 153 patients, mild neutropaenia (grade 1-2) occurred in 60 patients (39%) and severe neutropaenia (grade 3-4) occurred in 46 patients (30%). The other 47 patients (31%) did not experience neutropaenia. According to a multivariate Cox model with time-varying covariates, hazard ratios (HRs) of death were 0.55 (95% confidence interval (CI), 0.31-0.98; P = 0.044) for patients with mild neutropaenia and 0.35 (95% Cl, 0.18-0.66; P = 0.002) for those with severe neutropaenia. Both mild and severe neutropaenia during chemotherapy are associated with improved survival in patients with MCRC. Prospective trials are required to assess whether dosing adjustments based on neutropaenia may improve chemotherapy efficacy. Crown Copyright (C) 2009 Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:1757 / 1763
页数:7
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