Chemotherapy dose per kilogram lean body mass increased dose-limiting toxicity event in male head and neck cancer with taxane and platinum-based induction therapy
Abstract Background This study aimed to determine whether drug doses per kilogram of lean body mass (LBM) were associated with dose-limiting toxicity (DLT) events in head and neck cancer (HNC) patients. Methods This retrospective cohort study included 179 HNC patients who underwent induction chemoth...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-10-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-022-10152-y |
| _version_ | 1828318066692325376 |
|---|---|
| author | Chuan-Jen Hung Bor-Hwang Kang Keng-Ming Chang Ying-Ying Kang Chun-Hao Yin Ching-Chih Lee |
| author_facet | Chuan-Jen Hung Bor-Hwang Kang Keng-Ming Chang Ying-Ying Kang Chun-Hao Yin Ching-Chih Lee |
| author_sort | Chuan-Jen Hung |
| collection | DOAJ |
| description | Abstract Background This study aimed to determine whether drug doses per kilogram of lean body mass (LBM) were associated with dose-limiting toxicity (DLT) events in head and neck cancer (HNC) patients. Methods This retrospective cohort study included 179 HNC patients who underwent induction chemotherapy (IC) at a medical center from May 1, 2014, to May 31, 2021. HNC patients’ characteristics, tumor factors, IC regimen and dose, laboratory data, and body composition factors, including lean body mass (LBM) and skeletal muscle index (SMI), derived from CT, MRI, or PET scan images and drug dose per kilogram LBM were recorded. Dose-limiting toxicity (DLT) events were regarded as the primary outcome. Multivariate logistic regression was used to establish a novel risk score for DLT events by the abovementioned variables. The above-mentioned risk score was validated in another cohort. Results The overall DLT events during the first cycle of IC for 179 HNC patients was 24%. After stratifying by gender, docetaxel per kilogram LBM > 2.52 mg/kg (adjusted odds ratio [aOR]: 3.18; 95% confidence interval [CI], 1.25–8.09), pre-treatment glutamic pyruvic transaminase (GPT) > 40 U/L (aOR, 2.61; 95% CI, 1.03–6.64), and history of chronic liver diseases (aOR, 3.98; 95% CI, 1.03–15.46) were significant variables in male HNC patients. The DLT events risk was categorized by summation of the above-mentioned risk factors for male HNC patients. Three risk groups were stratified by overall event of 17.6%, 25.8%, and 75%. The above-mentioned risk score had an acceptable discriminatory ability in another validation cohort. Conclusions Among male HNC patients treated with IC, docetaxel per kilogram LBM more than 2.52 mg/kg, pre-treatment GPT > 40 U/L, and history of chronic liver disease were significant risk factors for DLT events. Identifying high-risk patients could help physicians prevent severe/fatal complications among HNC patients undergoing IC, especially for the male individuals. |
| first_indexed | 2024-04-13T17:36:44Z |
| format | Article |
| id | doaj.art-27e4e6c2700b4a598e8edddcdbefc14d |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-13T17:36:44Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-27e4e6c2700b4a598e8edddcdbefc14d2022-12-22T02:37:19ZengBMCBMC Cancer1471-24072022-10-012211910.1186/s12885-022-10152-yChemotherapy dose per kilogram lean body mass increased dose-limiting toxicity event in male head and neck cancer with taxane and platinum-based induction therapyChuan-Jen Hung0Bor-Hwang Kang1Keng-Ming Chang2Ying-Ying Kang3Chun-Hao Yin4Ching-Chih Lee5Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General HospitalDepartment of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General HospitalDepartment of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General HospitalDepartment of Pharmacy, Kaohsiung Veterans General HospitalDepartment of Medical Education and Research, Kaohsiung Veterans General HospitalDepartment of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General HospitalAbstract Background This study aimed to determine whether drug doses per kilogram of lean body mass (LBM) were associated with dose-limiting toxicity (DLT) events in head and neck cancer (HNC) patients. Methods This retrospective cohort study included 179 HNC patients who underwent induction chemotherapy (IC) at a medical center from May 1, 2014, to May 31, 2021. HNC patients’ characteristics, tumor factors, IC regimen and dose, laboratory data, and body composition factors, including lean body mass (LBM) and skeletal muscle index (SMI), derived from CT, MRI, or PET scan images and drug dose per kilogram LBM were recorded. Dose-limiting toxicity (DLT) events were regarded as the primary outcome. Multivariate logistic regression was used to establish a novel risk score for DLT events by the abovementioned variables. The above-mentioned risk score was validated in another cohort. Results The overall DLT events during the first cycle of IC for 179 HNC patients was 24%. After stratifying by gender, docetaxel per kilogram LBM > 2.52 mg/kg (adjusted odds ratio [aOR]: 3.18; 95% confidence interval [CI], 1.25–8.09), pre-treatment glutamic pyruvic transaminase (GPT) > 40 U/L (aOR, 2.61; 95% CI, 1.03–6.64), and history of chronic liver diseases (aOR, 3.98; 95% CI, 1.03–15.46) were significant variables in male HNC patients. The DLT events risk was categorized by summation of the above-mentioned risk factors for male HNC patients. Three risk groups were stratified by overall event of 17.6%, 25.8%, and 75%. The above-mentioned risk score had an acceptable discriminatory ability in another validation cohort. Conclusions Among male HNC patients treated with IC, docetaxel per kilogram LBM more than 2.52 mg/kg, pre-treatment GPT > 40 U/L, and history of chronic liver disease were significant risk factors for DLT events. Identifying high-risk patients could help physicians prevent severe/fatal complications among HNC patients undergoing IC, especially for the male individuals.https://doi.org/10.1186/s12885-022-10152-yHead and neck cancerInduction chemotherapyBody composition factorChemotherapy dose per kilogram lean body mass |
| spellingShingle | Chuan-Jen Hung Bor-Hwang Kang Keng-Ming Chang Ying-Ying Kang Chun-Hao Yin Ching-Chih Lee Chemotherapy dose per kilogram lean body mass increased dose-limiting toxicity event in male head and neck cancer with taxane and platinum-based induction therapy BMC Cancer Head and neck cancer Induction chemotherapy Body composition factor Chemotherapy dose per kilogram lean body mass |
| title | Chemotherapy dose per kilogram lean body mass increased dose-limiting toxicity event in male head and neck cancer with taxane and platinum-based induction therapy |
| title_full | Chemotherapy dose per kilogram lean body mass increased dose-limiting toxicity event in male head and neck cancer with taxane and platinum-based induction therapy |
| title_fullStr | Chemotherapy dose per kilogram lean body mass increased dose-limiting toxicity event in male head and neck cancer with taxane and platinum-based induction therapy |
| title_full_unstemmed | Chemotherapy dose per kilogram lean body mass increased dose-limiting toxicity event in male head and neck cancer with taxane and platinum-based induction therapy |
| title_short | Chemotherapy dose per kilogram lean body mass increased dose-limiting toxicity event in male head and neck cancer with taxane and platinum-based induction therapy |
| title_sort | chemotherapy dose per kilogram lean body mass increased dose limiting toxicity event in male head and neck cancer with taxane and platinum based induction therapy |
| topic | Head and neck cancer Induction chemotherapy Body composition factor Chemotherapy dose per kilogram lean body mass |
| url | https://doi.org/10.1186/s12885-022-10152-y |
| work_keys_str_mv | AT chuanjenhung chemotherapydoseperkilogramleanbodymassincreaseddoselimitingtoxicityeventinmaleheadandneckcancerwithtaxaneandplatinumbasedinductiontherapy AT borhwangkang chemotherapydoseperkilogramleanbodymassincreaseddoselimitingtoxicityeventinmaleheadandneckcancerwithtaxaneandplatinumbasedinductiontherapy AT kengmingchang chemotherapydoseperkilogramleanbodymassincreaseddoselimitingtoxicityeventinmaleheadandneckcancerwithtaxaneandplatinumbasedinductiontherapy AT yingyingkang chemotherapydoseperkilogramleanbodymassincreaseddoselimitingtoxicityeventinmaleheadandneckcancerwithtaxaneandplatinumbasedinductiontherapy AT chunhaoyin chemotherapydoseperkilogramleanbodymassincreaseddoselimitingtoxicityeventinmaleheadandneckcancerwithtaxaneandplatinumbasedinductiontherapy AT chingchihlee chemotherapydoseperkilogramleanbodymassincreaseddoselimitingtoxicityeventinmaleheadandneckcancerwithtaxaneandplatinumbasedinductiontherapy |