Impact of Comorbidity on Antiemetic Efficacy in Patients with Esophageal Cancer Treated with Cisplatin-Based Chemotherapy: A Retrospective Study from Japan.
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引用次数: 0
Abstract
Introduction: Cancer patients often have comorbidities due to the aging population or various other factors. However, clinical trials typically exclude specific severe comorbidities, and no prior study has examined their impact on antiemetic efficacy. Our previous research suggested that antiemetic efficacy might be higher in patients with diabetes mellitus (DM) compared to those without DM because of cortisol and substance P. To further investigate this, the current study analyzed which comorbidities affected chemotherapy-induced nausea and vomiting in patients with esophageal cancer treated with cisplatin-based chemotherapy.
Methods: This retrospective study enrolled Japanese patients with esophageal cancer who received fluorouracil and cisplatin (FP) combination chemotherapy as their initial treatment. The primary endpoint was the total control (TC) rate during the first cycle, defined as no emetic episodes, no nausea, and no rescue medication use over the overall period (0-120 h) measured by patients' diary or medical staff interview. Univariate and multivariate logistic regression models were used to analyze the TC rate, including previously reported risk factors (age, sex, performance status, body mass index, cisplatin dose, and number of prophylactic antiemetic agents). Comorbidities showing significance in the univariate analysis were further assessed in the multivariate analysis. The significance level was set at 5%.
Results: Among the 285 eligible patients, the prevalence of comorbidities was as follows: hypertension (36.8%), DM (17.9%), cardiovascular disease (10.6%), and hyperlipidemia (9.5%). Multivariate analysis revealed a significantly higher TC rate during the overall period in patients with cardiovascular disease (50.0%) compared to those without one (32.5%) (adjusted odds ratio 0.455, 95% confidence interval 0.207-0.999, p = 0.0499).
Conclusions: Antiemetic regimen appeared to be more effective in patients with esophageal cancer and cardiovascular disease during the overall period when compared to patients without one. The clinical trial stratified by whether cardiovascular disease should be conducted in the further.
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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