Nail Toxicity after Treatment with Docetaxel: A Prospective Analysis in Patients with Advanced Non-small Cell Lung Cancer

• Published in: Japanese journal of clinical oncology Vol. 37; no. 6; pp. 424 - 428
• Main Authors: Hong, Junshik, Park, Se Hoon, Choi, Soo Jin, Lee, Seok Ho, Lee, Kyu Chan, Lee, Jae-Ik, Kyung, Sun Young, An, Chang Hyeok, Lee, Sang Pyo, Park, Jeong Woong, Jeong, Sung Hwan, Nam, Eunmi, Bang, Soo-Mee, Cho, Eun Kyung, Shin, Dong Bok, Lee, Jae Hoon
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.06.2007; Oxford Publishing Limited (England)
• Subjects: Aged; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - toxicity; Antineoplastic Combined Chemotherapy Protocols - toxicity; Carcinoma, Non-Small-Cell Lung - drug therapy; chemotherapy; docetaxel; Drug Administration Schedule; Humans; Lung cancer; nail changes; Prospective Studies; Taxoids - administration & dosage; Taxoids - toxicity; docetaxel; nail changes; chemotherapy
• ISSN: 0368-2811; 1465-3621
• DOI: 10.1093/jjco/hym042

Objective Nail toxicity is one of the most frequent non-hematologic toxicities of docetaxel and often deteriorates patients' quality of life, leading to treatment discontinuation. To define the incidence of nail change as well as its association with specific risk factors, we prospectively investigated data of 84 consecutive patients with advanced non-small cell lung cancer who received first-line docetaxel/cisplatin combination chemotherapy. Methods Chemotherapy-naïve patients were treated with docetaxel, either 3-weekly or weekly, in combination with cisplatin. All patients received adequate premedications including corticosteroids, antiemetics and intravenous hydration. Toxicity was evaluated using National Cancer Institute (NCI) CTCAE version 3. Results Twenty-two patients (26%) developed nail changes, including nine (11%) with grade 3. Nine patients who developed grade 3 nail changes (seven of whom received weekly docetaxel) were not able to complete planned chemotherapy despite topical and/or oral antibiotic treatment. Most occurrences of nail changes were diagnosed in patients who were treated with weekly schedule (P = 0.02). The number of chemotherapy cycles and cumulative docetaxel doses were strongly associated with the development of nail changes. The cumulative hazard of developing nail changes increased above 10% after 2.8 months up to 40% at 6 months. A multivariate analysis of factors associated with the development of nail changes identified the following to have independent adverse significance: weekly docetaxel administration (odds ratio, 0.084; 95% CI, 0.014–0.510; P = 0.01) and the number of chemotherapy cycles given (odds ratio, 0.232; 95% CI, 0.067–0.805; P = 0.02). Conclusion Nail changes occur with more frequent and prolonged use of docetaxel.