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Purpose <p>Carboplatin (CBDCA) plus pemetrexed (PEM) is one of the most effective regimens for treating thoracic cancer. Rash, which is mainly caused by PEM, occurs in 15–30% of patients. Dexamethasone administration for 3 days is recommended to manage rash, chemotherapy-induced nausea, and vomiting in this regimen. However, the nature of the PEM-induced rashes is not fully understood. Consequently, we aimed to identify the risk factors associated with rash development under dexamethasone prophylaxis in CBDCA + PEM treatment.</p> Methods <p>Patients with thoracic cancer who underwent CBDCA + PEM treatment (<i>n</i> = 133) were retrospectively assessed. The primary endpoint of the present study was to identify the risk factor(s) for the incidence of all-grade rash in the first cycle. Factors affecting the incidence during all treatment cycles were also evaluated.</p> Results <p>The incidence of all-grade rash in the first cycle was 24.1%, including 16.5% for grade 1, 5.3% for grade 2, and 2.3% for grade 3, respectively. Moreover, that in all cycles, it was 27.1%, with 18.8% for grade 1, 6.0% for grade 2, and 2.3% for grade 3. Multivariate logistic regression analyses identified that age &lt; 65&#xa0;years was the singular independent risk factor for rash development in the first and all cycles (adjusted odds ratio, 2.79; 95% confidence interval, 1.17–6.67; <i>p</i> = 0.02 for the first cycle, 3.03, 1.29–7.09; <i>p</i> = 0.01 for all cycles).</p> Conclusion <p>Our study revealed that patients aged &lt; 65&#xa0;years were at a significantly higher risk of rash development during CBDCA + PEM chemotherapy with dexamethasone prophylaxis than patients ≥ 65&#xa0;years of age.</p>

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Younger age as a risk factor for rash development in pemetrexed and carboplatin treatment with dexamethasone prophylaxis

  • 期刊论文

  • 发表日期：

    2025年10月11日

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  • Yoshitaka Saito,
  • Osamu Taniguchi,
  • Yoh Takekuma,
  • Jun Sakakibara-Konishi,
  • Yasushi Shimizu,
  • Ichiro Kinoshita,
  • Mitsuru Sugawara

摘要

Purpose

Carboplatin (CBDCA) plus pemetrexed (PEM) is one of the most effective regimens for treating thoracic cancer. Rash, which is mainly caused by PEM, occurs in 15–30% of patients. Dexamethasone administration for 3 days is recommended to manage rash, chemotherapy-induced nausea, and vomiting in this regimen. However, the nature of the PEM-induced rashes is not fully understood. Consequently, we aimed to identify the risk factors associated with rash development under dexamethasone prophylaxis in CBDCA + PEM treatment.

Methods

Patients with thoracic cancer who underwent CBDCA + PEM treatment (n = 133) were retrospectively assessed. The primary endpoint of the present study was to identify the risk factor(s) for the incidence of all-grade rash in the first cycle. Factors affecting the incidence during all treatment cycles were also evaluated.

Results

The incidence of all-grade rash in the first cycle was 24.1%, including 16.5% for grade 1, 5.3% for grade 2, and 2.3% for grade 3, respectively. Moreover, that in all cycles, it was 27.1%, with 18.8% for grade 1, 6.0% for grade 2, and 2.3% for grade 3. Multivariate logistic regression analyses identified that age < 65 years was the singular independent risk factor for rash development in the first and all cycles (adjusted odds ratio, 2.79; 95% confidence interval, 1.17–6.67; p = 0.02 for the first cycle, 3.03, 1.29–7.09; p = 0.01 for all cycles).

Conclusion

Our study revealed that patients aged < 65 years were at a significantly higher risk of rash development during CBDCA + PEM chemotherapy with dexamethasone prophylaxis than patients ≥ 65 years of age.