年轻发作的结直肠癌:与治疗相关的恶心,吐和腹
Gianluca Mauri1,2, Martino Pedrani1,2, Silvia Ghezzi2
1Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milano, Italy.
BMJ supportive & palliative care
|June 21, 2023
概括
早发性结肠直肠癌患者比老年人更容易出现恶心和吐. 建议遵守临床指南,需要进一步的研究,以加强早期结直肠癌 (EO-CRC) 护理中的抗策略.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
背景情况:
- 早期结直肠癌 (EO-CRC) 的发病率在全球范围内正在上升.
- 临床医生可能会运用与年龄相关的偏见,导致强化治疗,但没有证明EO-CRC患者的生存益处.
- 有限的数据存在于EO-CRC的治疗相关毒性.
研究的目的:
- 研究早期结直肠癌 (EO-CRC) 患者中恶心,吐和腹的发生率.
- 为了比较EO-CRC和老年结直肠癌患者之间的与治疗相关的毒性.
- 确定EO-CRC中毒性增加的潜在风险因素.
主要方法:
- 在 MEDLINE/PubMed,EMBASE 和 Scopus 的系统文献搜索.
- 将报告恶心,吐和腹的研究纳入EO-CRC (年龄<50岁).
- 分析了来自9篇全文文章的数据,涵盖了59,783名患者,其中包括8,681名EO-CRC患者.
主要成果:
- 与老年患者相比,EO-CRC患者的恶心和吐发生率更高.
- 在EO-CRC和老年患者之间没有观察到腹发病率的显著差异.
- 在EO-CRC中,恶心/吐增加的潜在风险因素包括腹膜干扰,年龄<40岁,女性性别,低于最佳的准则遵守,以及使用氧化.
结论:
- 与老年同行相比,EO-CRC患者的恶心和吐率较高,但腹率相似或较低.
- 建议遵守当前关于结直肠癌治疗的临床指南.
- 需要进行进一步的研究,以确定EO-CRC是否需要增强的抗emetic协议,特别是对于已识别的风险因素的患者.
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