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Evaluation of the effects and adverse drug reactions of low-dose dexamethasone premedication with weekly docetaxel

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Abstract

Purpose

A weekly docetaxel regimen had comparable efficacy with a tri-weekly schedule and caused significantly less severe neutropenia and febrile neutropenia. Therefore, a weekly docetaxel regimen has become increasingly common in cancer treatment. Premedication with corticosteroids can effectively prevent or reduce the severity of hypersensitivity and fluid retention. However, no recommended steroid dosage for a weekly docetaxel regimen has been established to date. The aim of this study is to compare the efficacy and complications of two different weekly docetaxel premedication protocols.

Methods

We retrospectively compared the hypersensitivity, hyperglycemia, and infection incidence associated with two weekly docetaxel premedication protocols. The control group (dexamethasone 10 mg intravenously and 4 mg orally every 12 h for four doses, starting 1 h before docetaxel administration) patients started weekly docetaxel chemotherapy between May 2012 and April 2013 at Seoul National University Hospital, and the experimental group (dexamethasone 10 mg intravenously 1 h prior to each docetaxel administration) patients started weekly docetaxel chemotherapy between May 2013 and April 2014.

Results

In total, 109 patients in the control group and 97 patients in the experimental group were included in this study, and there were no statistically significant differences in baseline characteristics between the two groups. The incidence of hypersensitivity and hyperglycemia were similar, but infections were observed significantly less in the experimental group (p = 0.020, OR = 0.408, 0.0190–0.0879).

Conclusions

A low-dose dexamethasone premedication protocol has comparable efficacy in the prevention of docetaxel hypersensitivity with fewer infection complications. Therefore, we recommend a low-dose dexamethasone premedication protocol for weekly docetaxel regimens.

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Authors and Affiliations

  1. Department of Clinical Pharmacy, College of Pharmacy, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Gangwon-do, 24341, Republic of Korea

    Rae Young Kang, Kyung Sook Yoo & Yu Jeung Lee

  2. Department of Pharmacy, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Rae Young Kang & Hyeon Ju Han

  3. Korea Pharmaceutical Information Center, 194 Hyoryeong-ro, Seocho-gu, Seoul, 06708, Republic of Korea

    Kyung Sook Yoo

  4. College of Pharmacy, Institute of Pharmaceutical Science and Technology, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, Ansan, Gyeonggi-do, 15588, Republic of Korea

    Ju-Yeun Lee

  5. Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Se-Hoon Lee & Dong-Wan Kim

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  1. Rae Young Kang
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Correspondence to Yu Jeung Lee.

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Kang, R.Y., Yoo, K.S., Han, H.J. et al. Evaluation of the effects and adverse drug reactions of low-dose dexamethasone premedication with weekly docetaxel. Support Care Cancer 25, 429–437 (2017). https://doi.org/10.1007/s00520-016-3420-y

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  • DOI: https://doi.org/10.1007/s00520-016-3420-y

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