The pathophysiological mechanism of fluid retention in advanced cancer patients treated with docetaxel, but not receiving corticosteroid comedication
| Autor: | D. Oulid-Aissa, A. Behar, M. D. Brun, A. Maurel, D. Hille, F. Feuilhade De Chauvin, Eric Pujade-Lauraine, G. Lagrue |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
medicine.medical_specialty Paclitaxel medicine.drug_class medicine.medical_treatment Urology Phases of clinical research Breast Neoplasms Docetaxel Adenocarcinoma Lymphatic System Adrenal Cortex Hormones Edema medicine Humans Neoplasm Invasiveness Pharmacology (medical) Infusions Intravenous Aged Flavonoids Ovarian Neoplasms Pharmacology Chemotherapy Dose-Response Relationship Drug business.industry Urinary retention Original Articles Middle Aged Water-Electrolyte Balance Antineoplastic Agents Phytogenic Surgery Regimen Corticosteroid Drug Therapy Combination Female Taxoids Premedication medicine.symptom business medicine.drug |
| Zdroj: | British Journal of Clinical Pharmacology. 43:653-658 |
| ISSN: | 0306-5251 |
| Popis: | Aims Fluid retention is a phenomenon associated with taxoids. The principal objective of this study was to investigate the pathophysiological mechanism of docetaxel-induced fluid retention in advanced cancer patients. Methods Docetaxel was administered as a 1 h intravenous infusion every 3 weeks, for at least 4–6 consecutive cycles, to patients with advanced breast (n=21) or ovarian (n=3) carcinoma, who had received previous chemotherapy, 21 for advanced disease. Phase II clinical trials have shown that 5 day corticosteroid comedication, starting 1 day before docetaxel infusion, significantly reduces the incidence and severity of fluid retention. This prophylactic corticosteroid regimen is currently recommended for patients receiving docetaxel but was not permitted in this study because of its possible interference with the underlying pathophysiology of the fluid retention. Results Fluid retention occurred in 21 of the 24 patients but was mainly mild to moderate, with only five patients experiencing severe fluid retention. Eighteen patients received symptomatic flavonoid treatment, commonly prescribed after the last cycle. Specific investigations for fluid retention confirmed a relationship between cumulative docetaxel dose and development of fluid retention. Capillary filtration test analysis showed a two-step process for fluid retention generation, with progressive congestion of the interstitial space by proteins and water starting between the second and the fourth cycle, followed by insufficient lymphatic drainage. Conclusions A vascular protector such as micronized diosmine hesperidine with recommended corticosteroid premedication and benzopyrones may be useful in preventing and treating docetaxel-induced fluid retention. |
| Databáze: | OpenAIRE |
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