Background: Colorectal cancer (CRC) patients experience multiple types of chemotoxicity affecting treatment compliance, survival, and quality of life (QOL). Prior research shows clinician-reported chemotoxicity (i.e., grading scales or diagnostic codes) predicts rehospitalization and cancer survival. However, a comprehensive synthesis of clinician-reported chemotoxicity is still lacking. Objectives: We conducted a systematic review and meta-analysis to determine chemotoxicity’s prevalence and risk factors in CRC. Methods: A systematic search from 2009 to 2024 yielded 30 studies for review, with 25 included in the meta-analysis. Results: Pooled prevalences of overall, non-hematological, and hematological moderate-to-severe toxicities were 45.7%, 39.2%, and 25.3%, respectively. The most common clinician-reported chemotoxicities were gastrointestinal (GI) toxicity (22.9%) and neuropathy or neutropenia (17.9%). Significant risk factors at baseline were malnutritional status, frailty, impaired immune or hepato-renal functions, short telomere lengths, low gut lactobacillus levels, age, female sex, aggressive chemotherapy, and low QOL. Age was associated with neutropenia (β: −1.44) and GI toxicity (β:1.85) (p-values < 0.01). Older adults (>65 y.o.) had higher prevalences of overall (OR: 1.14) and GI (OR: 1.65) toxicities, but a lower prevalence of neutropenia (OR: 0.65) than younger adults (p-values < 0.05). Conclusions. Our findings highlight the importance of closely monitoring and managing chemotoxicity in CRC patients receiving chemotherapy.
背景：结直肠癌（CRC）患者常经历多种类型的化疗毒性反应，这些反应影响治疗依从性、生存期及生活质量（QOL）。既往研究表明，临床医生报告的化疗毒性（如分级量表或诊断代码）可预测再住院率和癌症生存率。然而，目前仍缺乏对临床医生报告的化疗毒性进行全面综合的分析。目的：本研究通过系统综述和荟萃分析，旨在明确结直肠癌患者化疗毒性的发生率及其风险因素。方法：对2009年至2024年的文献进行系统检索，共纳入30项研究进行综述，其中25项纳入荟萃分析。结果：总体、非血液学及血液学中重度毒性的汇总发生率分别为45.7%、39.2%和25.3%。最常见的临床医生报告的化疗毒性为胃肠道毒性（22.9%）以及神经病变或中性粒细胞减少症（17.9%）。基线期显著的风险因素包括营养不良状态、衰弱、免疫功能或肝肾功能受损、端粒长度缩短、肠道乳酸杆菌水平低、年龄、女性、强化化疗以及低生活质量。年龄与中性粒细胞减少症（β: −1.44）和胃肠道毒性（β:1.85）相关（p值 < 0.01）。与年轻患者相比，老年患者（>65岁）总体毒性（OR: 1.14）和胃肠道毒性（OR: 1.65）的发生率更高，但中性粒细胞减少症的发生率较低（OR: 0.65）（p值 < 0.05）。结论：本研究结果强调了在接受化疗的结直肠癌患者中密切监测和管理化疗毒性的重要性。
肿瘤(癌症)患者之家