Objective. The aim of this study is to evaluate the effect of oral de xamethaso ne in attenuating palmar-plantar erythrodysesthesias (PPE) in Doxil-treated patients for gynecologic malignancies. Methods. An IRB-appr...Objective. The aim of this study is to evaluate the effect of oral de xamethaso ne in attenuating palmar-plantar erythrodysesthesias (PPE) in Doxil-treated patients for gynecologic malignancies. Methods. An IRB-approved prospective cas e study was conducted in patients with recurrent gynecologic malignancies who we re treated with Doxil(50 mg/m2) on a 28-day cycle. Patients experiencing grad es Ⅱ-ⅣPPE were delayed until resolution then retreated without dose reduction and with a tapering oral dexamethasone regimen (8 mg BID days -1 to 4; 4 mg BI D day 5; 4 mg day 6). Standard treatment for grades Ⅱ-ⅣPPE in those not recei ving dexamethasone was weekly dose delay until resolution of symptoms up to 2 we eks. If resolution occurred within 3 weeks of delay, a 25%dose reduction was ma de. Persistent grades Ⅲ/ⅣPPE resulted in withdrawal of Doxil. Results. Twent y-three patients (ovarian-16, uterine-7) were treated between January 1998 an d December 2000. The median number of cycles administered was 5 (range 1-20). N ine patients (39%) developed grades Ⅱ-ⅣPPE.All nine patients receivedmore th an five cycles of Doxil. The median time to PPE was 3 cycles (range 2-5). Six out of nine PPE patients received scheduled dose dexamethasone. All six had com plete or near complete resolution of PPE and all continued treatment without sub sequent dose modification. All three of the nine PPE patients not receiving dexa methasone required treatment delays and were dose reduced. Conclusion. Oral dexa methasone is effective in attenuating or eliminating Doxil-induced PPE. The u se of the dexamethasone regimen prevents treatment delay and dose reduction.展开更多
文摘Objective. The aim of this study is to evaluate the effect of oral de xamethaso ne in attenuating palmar-plantar erythrodysesthesias (PPE) in Doxil-treated patients for gynecologic malignancies. Methods. An IRB-approved prospective cas e study was conducted in patients with recurrent gynecologic malignancies who we re treated with Doxil(50 mg/m2) on a 28-day cycle. Patients experiencing grad es Ⅱ-ⅣPPE were delayed until resolution then retreated without dose reduction and with a tapering oral dexamethasone regimen (8 mg BID days -1 to 4; 4 mg BI D day 5; 4 mg day 6). Standard treatment for grades Ⅱ-ⅣPPE in those not recei ving dexamethasone was weekly dose delay until resolution of symptoms up to 2 we eks. If resolution occurred within 3 weeks of delay, a 25%dose reduction was ma de. Persistent grades Ⅲ/ⅣPPE resulted in withdrawal of Doxil. Results. Twent y-three patients (ovarian-16, uterine-7) were treated between January 1998 an d December 2000. The median number of cycles administered was 5 (range 1-20). N ine patients (39%) developed grades Ⅱ-ⅣPPE.All nine patients receivedmore th an five cycles of Doxil. The median time to PPE was 3 cycles (range 2-5). Six out of nine PPE patients received scheduled dose dexamethasone. All six had com plete or near complete resolution of PPE and all continued treatment without sub sequent dose modification. All three of the nine PPE patients not receiving dexa methasone required treatment delays and were dose reduced. Conclusion. Oral dexa methasone is effective in attenuating or eliminating Doxil-induced PPE. The u se of the dexamethasone regimen prevents treatment delay and dose reduction.
