Assessment of Adrenal Function and Health-Related Quality of Life in Advanced Gastric Cancer Patients Who Received First-Line Chemotherapy

Oncology. 2016;90(5):248-54. doi: 10.1159/000445010. Epub 2016 Apr 13.

Abstract

Objective: We performed this prospective study to identify both the incidence of adrenal insufficiency (AI) and health-related quality of life (HRQOL) in advanced gastric cancer (AGC) patients who were treated with the S-1 plus cisplatin (SP) regimen as a first-line palliative chemotherapy.

Methods: We assessed adverse events (AEs) observed in 52 patients who received the SP regimen for AGC between January 2009 and June 2010 using the Common Toxicity Criteria Adverse Events (CTCAE) version 3.0. Adrenal function was assessed at baseline and 12 weeks after chemotherapy using the low-dose adrenocorticotropic hormone stimulation test. HRQOL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire version 3.0 (EORTC-QLQ C30).

Results: The incidence of AI was 30.8% (n = 16) and of AE observed 55% (n = 29) among 52 patients after 12 weeks of chemotherapy. Of 29 patients with AE, 34.4% (n = 10) were diagnosed with AI, and of 23 patients without AE, 26.1% (n = 6) were diagnosed with AI.

Conclusion: The incidence of secondary AI in AGC patients was not rare and was not correlated with the presence of nonspecific AEs. Although patients diagnosed with AI did not show any related symptoms, they are at risk of potentially life-threatening consequences. Thus, the evaluation of AI could be suggested for patients who received chemotherapy.

MeSH terms

  • Adrenal Glands / drug effects*
  • Adrenal Glands / metabolism*
  • Adrenal Insufficiency / blood*
  • Adrenal Insufficiency / chemically induced*
  • Adrenal Insufficiency / physiopathology
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Biomarkers / blood
  • Chemotherapy, Adjuvant
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects
  • Disease-Free Survival
  • Drug Combinations
  • Female
  • Gastrectomy
  • Health Status
  • Humans
  • Hydrocortisone / blood
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Oxonic Acid / administration & dosage
  • Oxonic Acid / adverse effects
  • Pilot Projects
  • Prospective Studies
  • Quality of Life*
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / physiopathology
  • Tegafur / administration & dosage
  • Tegafur / adverse effects
  • Treatment Outcome

Substances

  • Biomarkers
  • Drug Combinations
  • S 1 (combination)
  • Tegafur
  • Oxonic Acid
  • Cisplatin
  • Hydrocortisone