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

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.