Investigator
Renmin Hospital Of Wuhan University
Real-world data of docetaxel-induced liver injury among hospitalized patients in Wuhan, China: A retrospective analysis
This study aims to analyze the risk factors of docetaxel-induced liver injury to provide evidence for the clinical prevention and treatment of docetaxel-induced liver injury. A retrospective analysis of patients who received docetaxel chemotherapy regimen from January 2017 to April 2018 in Renmin Hospital of Wuhan University was conducted. Univariate analysis and multivariate logistic regression analysis with the forward stepwise method were used to assess the risk factors associated with liver injury induced by docetaxel. Receiver-operator characteristic curve analysis was performed to calculate the area under the receiver-operator characteristic curve (AUC). In the study, 223 (7.88%) patients were diagnosed as docetaxel-induced liver injury, among which the patients with ovarian cancer had the highest incidence rate (8.33%). By logistic regression analysis, hepatitis B virus carrier, diabetes, docetaxel plus nedaplatin, docetaxel plus capecitabine, docetaxel plus epirubicin, and docetaxel plus cyclophosphamide chemotherapy regimens, were independently associated with drug-induced liver injury during receiving chemotherapy, respectively. Among them, diabetes and docetaxel plus cyclophosphamide were protective factors, but the others were risk factors. Further analysis by the risk score and AUC showed that those factors contributed to an AUC of 0.693 (95% confidence interval = 0.660–0.727), with a predictive sensitivity of 70.9% and specificity of 61.6%. Docetaxel-induced liver injury with a relatively higher incidence should be addressed among ovary cancer patients. The predominant risk factors of docetaxel-induced liver injury included hepatitis B virus carrier and docetaxel combination regimens, and the protective factor was diabetic patients. Among these therapeutic combination regimens, docetaxel plus epirubicin, docetaxel plus nedaplatin, and docetaxel plus capecitabine could significantly increase the occurrence of docetaxel-induced liver injury during hospitalization respectively, while docetaxel plus cyclophosphamide regime might be safer. Therefore, for patients with these risk factors, it might be advisable to actively consider optimum management to reduce the occurrence of docetaxel-induced liver injury during hospitalization, particularly hepatic function test.
High-risk factors and predictive models for hemorrhagic chronic radiation proctitis
Hemorrhagic chronic radiation proctitis (CRP) is a common and challenging complication after pelvic radiation therapy. Identifying high-risk factors, predicting its occurrence, and optimizing radiotherapy plans are key to preventing hemorrhagic CRP. This study retrospectively examined potential risk factors and developed a nomogram to predict its onset. This retrospective study included cervical carcinoma patients who received pelvic radiotherapy at Chongqing University Cancer Hospital from March 2014 to December 2021. Hemorrhagic CRP was diagnosed by colonoscopy. Logistic regression identified factors for a nomogram model, which was evaluated using ROC curve, calibration curve, and decision curve analysis. Among 221 patients, 125 were diagnosed with hemorrhagic CRP, occurring at a median of 14.45 months after pelvic radiotherapy. Age (≥ 54 years), weight (< 52 kg), and radiation dose (≥ 72 Gy) were identified as risk factors. A nomogram was developed, with AUC values of 0.741 and 0.74 in the training and validation cohorts. Decision and clinical impact curves showed the model's benefit over a probability range of 0.25 to 0.85 in both sets. In this study, we constructed and developed a nomogram for predicting hemorrhagic CRP risk. The good results in calibration curves, ROC curve analysis, and decision curves indicated that the nomogram had promise for clinical application. It may serve as a reference for radiologists in designing radiotherapy plan to help mitigate the risk of hemorrhagic CRP.
Incidence and non-genetic risk factors of irinotecan-induced severe neutropenia in Chinese adult inpatients
To analyze the incidence and nongenetic risk factors of irinotecan-induced severe neutropenia in the hospital, and provide additional reference and help for clinical treatment. A retrospective analysis of patients who received irinotecan based chemotherapy from May 2014 to May 2019 in Renmin Hospital of Wuhan University was conducted. Univariate analysis and binary logistic regression analysis with the forward stepwise method were used to assess the risk factors associated with severe neutropenia induced by irinotecan. Of the 1312 patients treated with irinotecan-based regmines, only 612 patients met the inclusion criteria, and 32 patients developed irinotecan-induced severe neutropenia. In the univariate analysis, variables associated with severe neutropenia were tumor type, tumor stage, and therapeutic regimen. In the multivariate analysis, irinotecan plus lobaplatin, lung cancer or ovarian cancer, tumor stage T2, T3, and T4, were identified as risk factors that contributed independently to irinotecan-induced severe neutropenia (P < .05), respectively. The results showed that the incidence of irinotecan–induced severe neutropenia was 5.23% in the hospital. The risk factors included tumor type (lung cancer or ovarian cancer), tumor stage (T2, T3, and T4) and therapeutic regimen (irinotecan plus lobaplatin). Therefore, for patients with these risk factors, it might be advisable to actively consider optimum management to reduce the occurrence of irinotecan–induced severe neutropenia.
