鳥居 裕

OBJECTIVES: Chemotherapy-induced peripheral neuropathy (CIPN), a frequently occurring adverse event associated with paclitaxel/carboplatin (TC) combination therapy, causes limb pain and markedly reduces the patient's quality of life. Since zinc has been reported to be associated with neuropathic pain, we investigated the relationship between CIPN due to TC therapy and serum zinc levels. METHODS: The study included 13 patients with gynecological cancer whose serum zinc levels were measured before and during TC therapy. CIPN was classified into severity grades based on the Common Terminology Criteria for Adverse Events v5.0. A retrospective analysis was conducted on the relationship between the serum zinc level before TC therapy (PreZn), the minimum serum zinc level measured during TC therapy (MinZn), the MinZn/PreZn ratio, the number of TC treatment cycles, and the maximum grade of CIPN (MaxG) using Pearson's correlation coefficient. Moreover, an analysis was also conducted on clinical factors influencing MaxG, as well as fluctuations in serum zinc levels and CIPN grades for each cycle of TC therapy. RESULTS: A negative correlation was observed between the MinZn/PreZn ratio and MaxG (r=-0.557, p=0.048). The clinical factors influencing CIPN remained unclear, and the decrease in serum zinc levels and the aggravation of CIPN plateaued after the third cycle. CONCLUSIONS: If a decrease in serum zinc levels during TC therapy is smaller than before therapy, it may imply the existence of a causal relationship that suppresses the aggravation of CIPN.

BACKGROUND/AIM: The frequency rate of injection site reactions (ISR) due to fosaprepitant meglumine (Fos APR) has been shown to vary depending on the types of combined anticancer drug. This study aimed to elucidate the impact of Fos APR on ISR in patients receiving paclitaxel and carboplatin, with and without bevacizumab therapy (TC±Bev). PATIENTS AND METHODS: This study focused on patients with gynecologic cancer (n=93) who received TC±Bev administration at Fujita Health University Hospital from March 2016 to February 2020, and monitored up to six cycles. The patients were randomly assigned to the Fos APR group (n=47) and the Aprepitant (APR) group (n=46). Using Visual Infusion Phlebitis (VIP) scores, ISR was evaluated by comparing the VIP scores of all cycles using a linear mixed model. The risk factors that contribute to the occurrence of vascular pain throughout all cycles were also examined. RESULTS: The VIP scores of all cycles showed a near significant intergroup difference (p=0.071). Factors that affected the development of vascular pain included Fos APR and age (p=0.027 and 0.049, respectively). Regarding age, patients aged <65 years had a higher risk. Four patients underwent a switch from the originally assigned neurokinin-1 receptor antagonist; in all of these cases, Fos APR was changed to APR for vascular pain. CONCLUSION: Fos APR may increase the risk for ISR associated with TC±Bev therapy for gynecological cancer.