Difference in Adverse Reactions between Colorectal Cancer Patients with or without Spleen-kidney Yang Deficiency Syndrome after Oxaliplatin-containing Chemotherapy
Objective To compare the difference in adverse reactions after oxaliplatin-containing chemotherapy between colorectal cancer patients with or without spleen-kidney yang deficiency syndrome.Methods A retrospec-tive study was conducted using the electronic medical records of Beijing Hospital of Traditional Chinese Medicine,Capital Medical University.A total of 483 colorectal cancer patients from January 1,2009 to December 31,2022 were selected.Patients were divided into two groups based on their syndrome types,that was spleen-kidney yang defi-ciency syndrome(SKYDS)group(130 cases)and non-SKYDS group(353 cases).The incidence of adverse reac-tions including gastrointestinal reactions,liver damage,bone marrow suppression,and peripheral neurotoxicity after completing 2,4,6,and more than 6 cycles of chemotherapy was compared between the two groups.Univariate and multivariate logistic regression analyses were used to analyze the associations of age,gender,alcohol history,primary tumor location,tumor differentiation,tumor staging,chemotherapy courses,and syndrome types with the occurrence of gastrointestinal adverse reactions,liver function damage,bone marrow suppression and peripheral neurotoxicity in colorectal cancer patients who have completed 2,4,6 and more than 6 cycles of oxaliplatin-containing chemotherapy.Results There were significant differences in the occurrence of gastrointestinal reactions after completing 2,4,6 and more than 6 cycles of chemotherapy between the two groups(P<0.01),with much more severe conditions in SKYDS group than non-SKYDS group(P<0.01).There was no significant difference in liver function damage and bone marrow suppression between groups(P>0.05).There were statistically significant differences in the occur-rence of peripheral neurotoxicity after completion of 2 cycles(P=0.044),4 cycles(P=0.002)and more than 6 cycles(P<0.001)of chemothe-rapy,with higher rate in SKYDS group than the non-SKYDS group(P<0.05).Univariate analysis showed that female,patients with stage Ⅲ tumors and patients having completed≥6 cycles of chemotherapy had a higher incidence of bone marrow suppression(P<0.05),and patients with SKYDS had a higher incidence of gastrointestinal reactions(P<0.001).Patients with a history of drinking,stage Ⅳ cancer,and ≥6 cycles of chemo-therapy had a higher incidence of liver function injury(P<0.05).Patients with stage Ⅲ cancer,≥6 cycles of chemotherapy,and SKYDS had a higher incidence of peripheral neurotoxicity(P<0.05).Multivariate analysis showed that the risk factor for bone marrow suppression was chemotherapy ≥6 cycles(P=0.001),and SKYDS was the risk factor for gastrointestinal reaction(P<0.001).The risk factor for liver function damage was tumor stage Ⅳ(P=0.001)and SKYDS(P=0.039).All variables had no significant correlation with the occurrence of peripheral neurotoxicity.Conclusion For colorectal cancer patients,being diagnosed with SKYDS is a risk factor for develop-ing gastrointestinal adverse reactions and peripheral neurotoxicity following chemotherapy with an oxaliplatin-based regimen.
colorectal canceroxaliplatinadverse reactionsspleen-kidney yang deficiency syndromeretrospec-tive cohort study