title: Analysis of the risk factors for myelosuppression after chemoradiotherapy involving 5-fluorouracil and platinum for patients with esophageal cancer.
abstract: OBJECTIVE
  Myelosuppression is a serious adverse effect of chemotherapy, but its risk factors remain largely unknown. The present study retrospectively evaluated clinical data obtained before therapy to clarify the risk factors for myelosuppression after chemoradiotherapy in patients with esophageal cancer.
  
  
  METHODS
  One-hundred-and-eight patients who received 5-fluorouracil combined with platinum and 60Gy radiation for esophageal cancer were analyzed. The endpoint of this survey was the occurrence of grade 3 or higher myelosuppression (neutropenia, anemia or thrombocytopenia). Risk factors significantly related to myelosuppression were extracted using logistic regression analysis.
  
  
  RESULTS
  Grade 3 or higher neutropenia, anemia or thrombocytopenia occurred in 32.4%, 13.0% and 10.2% of the patients, respectively. According to the multivariate analysis, the risk factors included hoarseness, platelet count and the type of platinum for neutropenia; performance status and hemoglobin for anemia; and performance status, platelet count and serum creatinine concentration for thrombocytopenia (p<0.05).
  
  
  CONCLUSIONS
  It was found that performance status, bone marrow function and hoarseness are the most important factors for chemoradiotherapy-induced myelosuppression in esophageal cancer. The prediction of myelosuppression is expected to be useful for the determination of the appropriate therapeutic approach for each patient by a physician.
authors.affiliation: Promotion Center of Pharmaceutical Education Showa University School of Pharmacy, Tokyo, Japan. mari-k@pharm.showa-u.ac.jp
authors.forename: Mari
authors.initials: M
authors.lastname: Kogo
authors.forename: Manami
authors.initials: M
authors.lastname: Watahiki
authors.forename: Tomiko
authors.initials: T
authors.lastname: Sunaga
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kaneko
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Yoneyama
authors.forename: Michio
authors.initials: M
authors.lastname: Imawari
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kiuchi
mesh_terms: D000368:Aged; D000740:Anemia / Q000209:etiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000187:drug effects* / Q000528:radiation effects*; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000628:therapy*; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology; D010984:Platinum / Q000009:adverse effects; D012307:Risk Factors; D013921:Thrombocytopenia / Q000209:etiology
chemical_list: D010984:Platinum; D005472:Fluorouracil