多西他赛与紫杉醇治疗乳腺癌围手术期辅助治疗的眼部不良事件:倾向评分重叠加权分析。

IF 3 3区 医学 Q2 ONCOLOGY
Breast Cancer Research and Treatment Pub Date : 2025-07-01 Epub Date: 2025-05-13 DOI:10.1007/s10549-025-07720-8
Chikako Iwai, Atsushi Miyawaki, Takaaki Konishi, Akira Okada, Asahi Fujita, Taisuke Jo, Hideo Yasunaga
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引用次数: 0

摘要

背景:紫杉烷已知与几种眼部不良事件有关;然而,比较两种常用紫杉醇(docetaxel, DTX)和紫杉醇(paclitaxel, PTX)眼部不良事件风险的大规模数据仍然有限。因此,我们的目的是比较以DTX和ptx为基础的化疗方案的表显、囊样黄斑水肿和视神经病变的风险。方法:利用日本全国索赔数据库,我们确定了2014年4月至2022年11月期间接受新辅助或辅助紫杉烷化疗的6038例乳腺癌患者。数据分析于2024年进行。这项研究是在日本的多个转诊中心和社区医院进行的,提供了在不同医疗保健环境中基于紫杉烷的化疗实践的综合观点。研究对象包括6038例接受新辅助或辅助紫杉烷化疗的乳腺癌患者。入选标准包括年龄在18岁或以上的女性患者。使用连续抽样方法从全国索赔数据库中选择参与者。以DTX为基础化疗组(DTX组)与PTX为基础化疗组(PTX组)进行比较。在使用倾向评分-重叠加权法调整潜在混杂因素后,我们使用Cox比例风险回归模型估计了三种眼部不良事件的发生率和风险比(hr)。结果:6038例患者中,DTX组3829例,PTX组2209例。与PTX组相比,DTX组显泪的调整HR为1.69[95%可信区间(CI), 1.17 ~ 2.45]。对于囊样黄斑水肿和视神经病变,调整后的hr分别为0.74 (95% CI, 0.52 ~ 1.04)和0.72(0.47 ~ 1.11)。DTX组和PTX组的表色、囊样黄斑水肿和视神经病变的综合发生率无显著差异。结论:在接受紫杉烷类化疗的乳腺癌患者中,与PTX相比,DTX与更高的显色风险相关。然而,两组的黄斑囊样水肿和视神经病变发生率无显著差异。这些发现为乳腺癌患者紫杉烷化疗的眼部不良事件概况提供了有价值的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ocular adverse events of perioperative adjuvant docetaxel vs paclitaxel for breast cancer: propensity-score overlap-weighted analysis.

Background: Taxanes are known to be associated with several ocular adverse events; however, large-scale data comparing the risk of ocular adverse events between the two commonly used taxanes, docetaxel (DTX) and paclitaxel (PTX), remain limited. Therefore, we aimed to compare the risks of epiphora, cystoid macular edema, and optic neuropathy between DTX- and PTX-based chemotherapy regimens.

Methods: Using a nationwide claims database in Japan, we identified 6038 patients who initiated neoadjuvant or adjuvant taxane-based chemotherapy for breast cancer between April 2014 and November 2022. Data analysis was conducted in 2024. This study was conducted across multiple referral centers and community hospitals in Japan, providing a comprehensive view of taxane-based chemotherapy practices in diverse healthcare settings. Participants included 6038 patients diagnosed with breast cancer who initiated neoadjuvant or adjuvant taxane-based chemotherapy. Eligibility criteria included female patients aged 18 years or older. Participants were selected from a nationwide claims database using a consecutive sampling method. Patients who received DTX-based chemotherapy (DTX group) were compared with those who received PTX-based chemotherapy (PTX group). After adjusting for potential confounders using a propensity score-overlap weighting method, we estimated the incidence of the three ocular adverse events and hazard ratios (HRs) using Cox proportional hazards regression models.

Results: Among the 6038 eligible patients, 3829 were in the DTX group and 2209 in the PTX group. The adjusted HR for epiphora in the DTX group was 1.69 [95% confidence interval (CI), 1.17 to 2.45] compared with the PTX group. For cystoid macular edema and optic neuropathy, the adjusted HRs were 0.74 (95% CI, 0.52 to 1.04) and 0.72 (0.47 to 1.11), respectively. The composite incidence of epiphora, cystoid macular edema, and optic neuropathy did not differ significantly between the DTX and PTX groups.

Conclusion: Among patients receiving taxane-based chemotherapy for breast cancer, DTX was associated with a higher risk of epiphora compared with PTX. However, the incidence rates of cystoid macular edema and optic neuropathy did not differ significantly between the two groups. These findings offer valuable insights into the ocular adverse event profile of taxane-based chemotherapy in patients with breast cancer.

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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
342
审稿时长
1 months
期刊介绍: Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.
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