医療薬学
Online ISSN : 1882-1499
Print ISSN : 1346-342X
ISSN-L : 1346-342X
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FOLFOX 4 療法における末梢神経障害発症に関与する臨床的因子の検討
今井 徹早坂 正敏中馬 真幸濃沼 政美葉山 達也中山 敏光吉田 善一丹正 勝久
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2010 年 36 巻 5 号 p. 347-351

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Oxaliplatin (L-OHP) in combination with infusional 5-fluorouracil/leucovorin (FOLFOX) has been established as a core therapy for advanced and recurrent colorectal cancer.In this case,sensory neurotoxicity is its dose-limiting toxicity.We evaluated it using the Neurotoxicity Criteria of DEBIOPHARM and conducted a retrospective analysis to determine sensory neurotoxicity-associated clinical factors.
Seventy patients with advanced recurrent colorectal cancer who received FOLFOX 4 therapy from November 2005 to February 2008 were the subjects of the present study.The median number of courses until expression of grade 1 neurotoxicity was six (range 1~17 courses) and that for grade 2 neurotoxicity was ten (range 3~18 courses).
A logistic regression analysis performed to determine patient background and laboratory data that affect the incidence of sensory neurotoxicity revealed that risk factors involving sensory neurotoxicity were WBC(×~103/μL)[odds ration: 0.7556 (95% confidence interval:0.6740-0.8471)],Amylase (Logarithm natural)[1.7766:(1.0879-2.9011)],Transition [1.7850:(1.1647-2.7354)]and L-OHP cumulative dose (g)[2.2399:(1.5810-3.1734)].
These findings suggest that pharmacists should carefully monitor the rational symptoms in patients undergoing FOLFOX for advanced and recurrent colorectal cancer,particularly in those with risk factors for sensory neurotoxicity.

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