PDF(Pubmed)
Abstract：
Hand-foot syndrome (HFS) is a frequently occurring and treatment-requiring adverse effect of docetaxel. We previously reported that systemic dexamethasone (DEX) prevents the other docetaxel-induced adverse inflammatory effects in a dose-dependent manner. This study aimed to evaluate the dose-dependent efficacy of systemic DEX in attenuating HFS in patients with breast cancer receiving docetaxel. Patients with breast cancer receiving docetaxel (75 mg/m2)-containing regimens (n = 111) were divided into 4 and 8 mg/day DEX groups, with each DEX dose administered on days 2-4, and analyzed retrospectively. Development of all-grade HFS in all treatment cycles was significantly lower in the 8 mg group (50.0%) than in the 4 mg group (73.0%, P = 0.03), with primary endpoint accomplishment. Moreover, its development in the first cycle was also lower in the 8 mg group than in the 4 mg group. These results were confirmed in a propensity score-matched population. Logistic regression analysis suggested higher DEX dosage as an independent preventive factor (adjusted odds ratio 0.35; 95% confidence interval 0.14-0.86, P = 0.02 for all cycles; 0.26, 0.11-0.63, P = 0.003 for the first cycle). Our study suggests that systemic DEX prevents the occurrence of docetaxel-induced HFS in patients with breast cancer in a dose-dependent manner in a real-world setting.
摘要：
手足综合征（HFS）是多西他赛的常见且需要治疗的不良反应。我们先前报道了全身性地塞米松（DEX）以剂量依赖性方式预防其他多西他赛诱导的不良炎症反应。本研究旨在评估全身DEX在降低接受多西他赛的乳腺癌患者的HFS中的剂量依赖性疗效。接受多西他赛（75mg/m2）方案的乳腺癌患者（n=111）分为4和8mg/天DEX组，在第2-4天给予每种DEX剂量，并进行回顾性分析。在所有治疗周期中，所有级别HFS的发展在8mg组（50.0％）明显低于4mg组（73.0％，P=0.03),与主要终点成就。此外，8mg组第一个周期的发展也低于4mg组。这些结果在倾向得分匹配的人群中得到证实。Logistic回归分析表明，较高的DEX剂量是独立的预防因素（所有周期的校正比值比为0.35；95％置信区间为0.14-0.86，P=0.02；第一个周期为0.26，0.11-0.63，P=0.003）。我们的研究表明，在现实世界中，全身性DEX以剂量依赖性方式预防多西他赛诱导的乳腺癌患者HFS的发生。
