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Awareness of the adverse effects associated with prophylactic corticosteroid use during docetaxel therapy

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Abstract

Purpose

Weekly or tri-weekly docetaxel treatment mandates the use of dexamethasone to prevent toxicity. However, the adverse effects of prophylactic steroid use are often overlooked. We investigated the incidence of corticosteroid-associated adverse effects during docetaxel therapy, focusing on hyperglycemia and infection as well as the identification of possible risk factors.

Methods

This study was conducted through retrospective chart review of 632 patients who started docetaxel-based chemotherapy between July 2011 and June 2012 at Seoul National University Hospital. Hyperglycemia was defined as more than two random glucose levels >200 mg/dL. All documented episodes of infection that required treatment with antibiotics were regarded as infectious episodes.

Results

The incidences of hyperglycemia in overall patients and in patients without previous diabetes mellitus were 13.7 and 10.9 %, respectively. Infectious episodes greater than grade 2 and grade 3 developed in 29.6 and 19.9 % of patients, respectively. Multivariable logistic regression analysis showed that body mass index and previous diabetes mellitus were independent risk factors for hyperglycemia, whereas corticosteroid dose was not. Treatment duration and frequency of high blood glucose levels over 200 mg/dL were independent risk factors for infection.

Conclusions

Due to the significant difference in patient and treatment characteristics, we could not obtain meaningful comparisons between weekly and tri-weekly docetaxel administration regimens. This study suggests that adverse effects associated with prophylactic steroid use need to be recognized and optimally managed during docetaxel therapy.

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Conflict of interest

The authors have no conflict to disclose.

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Authors and Affiliations

  1. Department of Pharmacy, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Republic of Korea

    Ka-Eun Yoo, Rae Young Kang, Sung Yun Suh, Kwi Suk Kim & Hyang Sook Kim

  2. College of Pharmacy, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 120-750, Republic of Korea

    Ka-Eun Yoo & Byung Koo Lee

  3. College of Pharmacy, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Gangwon-do, 200-701, Republic of Korea

    Rae Young Kang & Yu Jeung Lee

  4. Department of Internal Medicine and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Republic of Korea

    Se-Hoon Lee

  5. College of Pharmacy, Institute of Pharmaceutical Science and Technology, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, Ansan, Gyeonggi-do, 426-791, Republic of Korea

    Ju-Yeun Lee

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  1. Ka-Eun Yoo
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Correspondence to Ju-Yeun Lee.

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Ka-Eun Yoo and Rae Young Kang contributed equally to this work.

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Yoo, KE., Kang, R.Y., Lee, JY. et al. Awareness of the adverse effects associated with prophylactic corticosteroid use during docetaxel therapy. Support Care Cancer 23, 1969–1977 (2015). https://doi.org/10.1007/s00520-014-2547-y

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  • DOI: https://doi.org/10.1007/s00520-014-2547-y

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