Correlation between Serum Albumin and Myelosuppression in Patients with Esophageal Cancer Treated with Chemoradiation Therapy

摘要

Concurrent chemoradiation therapy (CRT) with 5-fluorouracil (5-FU), cisplatin, and external radiation is a standard treatment for advanced local-regional esophageal cancer. Because the binding of cisplatin to albumin in the serum affects the distribution and excretion of cisplatin, hypoalbuminemia during CRT may affect the pharmacological antitumor activity of cisplatin and lead to side effects. Therefore, we analyzed the relationship between serum albumin levels and side effects, such as myelosuppression and nephrotoxicity, during CRT. A total of 115 patients with esophageal cancer who underwent CRT were divided into those with hypoalbuminemia (serum albumin <3.5g/dL before CRT) and those without hypoalbuminemia (serum albumin ≥3.5g/dL during CRT). Seven patients were included in the hypoalbuminemia group, whereas 11 patients were included in the nonhypoalbuminemia group. The toxicity profiles of the two groups suggested that myelosuppression was more evident in the hypoalbuminemia group than that in nonhypoalbuminemia group, although a significant difference was observed only in platelet counts. In contrast, there was no significant difference in nephrotoxicity between the groups. These results suggest that hypoalbuminemia in patients with esophageal cancer undergoing CRT with low-dose cisplatin and 5-FU may be associated with more-severe myelosuppression rather than with nephrotoxicity and that myelosuppression should be monitored carefully during CRT, particularly in patients with hypoalbuminemia.