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Neutropenia as a prognostic factor in advanced gastric cancer patients undergoing second-line chemotherapy with weekly paclitaxel.
- Source :
-
Annals of oncology : official journal of the European Society for Medical Oncology [Ann Oncol] 2010 Dec; Vol. 21 (12), pp. 2403-2409. Date of Electronic Publication: 2010 May 21. - Publication Year :
- 2010
-
Abstract
- Background: Neutropenia during chemotherapy has been reported to be a predictor of better survival in patients with several types of cancers, although there are no reports in pretreated patients.<br />Methods: We retrospectively analyzed 242 patients with advanced gastric cancer (AGC) who received weekly paclitaxel (Taxol) as second-line chemotherapy. Background characteristics and neutropenia as time-varying covariates (TVCs) were analyzed as prognostic factors.<br />Results: Of the 242 patients, mild neutropenia (grades 1-2) occurred in 101 patients (41.7%) and severe neutropenia (grades 3-4) occurred in 63 patients (26.0%). The other 78 patients (32.2%) did not experience neutropenia. According to a multivariate Cox model with neutropenia as a TVC, hazard ratios of death were 0.61 [95% confidence interval (CI) 0.43-0.85; P = 0.004] for patients with mild neutropenia and 0.61 (95% CI 0.41-0.88; P = 0.009) for those with severe neutropenia. Among the patients in landmark analysis (landmark of 2.5 months; median time to treatment failure of paclitaxel), mild and severe neutropenia remained significant prognostic factors.<br />Conclusions: Our results indicate that neutropenia during chemotherapy is associated with improved survival in patients with AGC who received weekly paclitaxel as second-line chemotherapy. Prospective trials are required to assess whether dosing adjustments based on neutropenia may improve chemotherapy efficacy.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antineoplastic Agents administration & dosage
Antineoplastic Agents adverse effects
Carcinoma mortality
Carcinoma pathology
Chemotherapy, Adjuvant
Disease Progression
Drug Administration Schedule
Female
Humans
Male
Middle Aged
Neutropenia diagnosis
Prognosis
Retrospective Studies
Stomach Neoplasms mortality
Stomach Neoplasms pathology
Survival Analysis
Biomarkers, Pharmacological analysis
Biomarkers, Pharmacological blood
Carcinoma diagnosis
Carcinoma drug therapy
Neutropenia chemically induced
Paclitaxel administration & dosage
Paclitaxel adverse effects
Stomach Neoplasms diagnosis
Stomach Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1569-8041
- Volume :
- 21
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Annals of oncology : official journal of the European Society for Medical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 20494962
- Full Text :
- https://doi.org/10.1093/annonc/mdq248