Correlation Between Duration of Docetaxel Administration and Epiphora Severity in Nasopharyngeal Carcinoma Patients
DOI:
https://doi.org/10.59784/glosains.v7i3.772Keywords:
Docetaxel, Epiphora, Munk Score, Nasopharyngeal CarcinomaAbstract
Background: Docetaxel, an effective chemotherapeutic agent for various cancers, including nasopharyngeal carcinoma, is associated with epiphora as a notable adverse effect.
Objective: This study aimed to investigate the correlation between the duration of docetaxel administration and the severity of epiphora, as assessed by the Munk score, in patients with nasopharyngeal carcinoma.
Methods: A descriptive cross-sectional study was undertaken at the Ophthalmology Polyclinic of Dr. Mohammad Hoesin Hospital, Palembang, from January to August 2024. The study sample comprised n=25 patients who met the research criteria. Epiphora severity was measured using the Munk score. Statistical analysis was performed using Spearman’s rank correlation test.
Results: The majority of patients were male (68.2%) and aged ≤50 years (77.3%). Most received an 80 mg docetaxel dose (91%) for six weeks (77.3%). Based on the Munk score, 86.4% of patients had a score of 1, and 13.6% had a score of 2. No significant associations were found between Munk score and gender (p=0.445), age (p=0.578), or docetaxel dose (p=1.000). However, the duration of docetaxel administration was significantly associated with Munk score (p=0.001) and showed a moderate positive correlation with epiphora severity (r=0.626; p=0.001).
Conclusion: Patients with a Munk score of 2 received docetaxel for a longer duration. A longer duration of docetaxel administration is associated with a higher Munk score for epiphora in nasopharyngeal carcinoma patients.
References
Acır, N. Ö., & Cetinkaya, S. (2025). The etiological spectrum of epiphora: Functional epiphora as an overlooked cause. Indian Journal of Ophthalmology, 73(10), 1432–1437. https://doi.org/10.4103/IJO.IJO_1641_24
Esmaeli, B., Hortobagyi, G., Esteva, F., Valero, V., Ahmadi, M. A., Booser, D., Ibrahim, N., Delpassand, E., & Arbuckle, R. (2002). Canalicular stenosis secondary to weekly docetaxel: a potentially preventable side effect. Annals of Oncology, 13(2), 218–221. https://doi.org/10.1093/annonc/mdf036
Garg, A., & Zhang, X. (2017). Lacrimal gland development: From signaling interactions to regenerative medicine. Developmental Dynamics, 246(12), 970–980.
Hong, S., Zhang, Y., Yu, G., Peng, P., Peng, J., Jia, J., Wu, X., Huang, Y., Yang, Y., & Lin, Q. (2021). Gemcitabine plus cisplatin versus fluorouracil plus cisplatin as first-line therapy for recurrent or metastatic nasopharyngeal carcinoma: final overall survival analysis of GEM20110714 phase III study. Journal of Clinical Oncology, 39(29), 3273–3282. https://doi.org/10.1200/JCO.21.00396
Hutajulu, S. H., Howdon, D., Taroeno-Hariadi, K. W., Hardianti, M. S., Purwanto, I., Indrasari, S. R., Herdini, C., Hariwiyanto, B., Ghozali, A., & Kusumo, H. (2021). Survival outcome and prognostic factors of patients with nasopharyngeal cancer in Yogyakarta, Indonesia: a hospital-based retrospective study. PLoS One, 16(2), e0246638. https://doi.org/10.1371/journal.pone.0246638
Kanno, M., Narita, N., Fujimoto, Y., Wakisaka, N., Yoshizaki, T., Kodaira, T., Makita, C., Sato, Y., Yamazaki, K., & Wakaoka, T. (2019). Third epidemiological analysis of nasopharyngeal carcinoma in the central region of Japan from 2006 to 2015. Cancers, 11(8), 1180. https://doi.org/10.3390/cancers11081180
Kim, N., Park, C., Park, D. J., Kim, H.-H., Kim, S., Kim, Y. J., Kim, J. H., Lee, J. S., Bang, Y.-J., & Khwarg, S. I. (2012). Lacrimal drainage obstruction in gastric cancer patients receiving S-1 chemotherapy. Annals of Oncology, 23(8), 2065–2071.
Limura, Y., Sakai, H., Nakajima, I., Kuroda, S., & Nakamura, M. (2026). Ocular toxicities associated with anticancer drug therapy in Asian patients: a literature review and practical management recommendations for non-ophthalmologic settings. International Journal of Clinical Oncology, 1–17.
Liu, S.-L., Sun, X.-S., Li, X.-Y., Chen, Q.-Y., Lin, H.-X., Wen, Y.-F., Guo, S.-S., Liu, L.-T., Xie, H.-J., & Tang, Q.-N. (2018). Liposomal paclitaxel versus docetaxel in induction chemotherapy using Taxanes, cisplatin and 5-fluorouracil for locally advanced nasopharyngeal carcinoma. BMC Cancer, 18(1), 1279. https://doi.org/10.1186/s12885-018-5192-x
Salehiniya, H., Mohammadian, M., Mohammadian-Hafshejani, A., & Mahdavifar, N. (2018). Nasopharyngeal cancer in the world: epidemiology, incidence, mortality and risk factors. World Cancer Res J, 5(1), e1046.
Sebastian, J., & Rathinasamy, K. (2023). Microtubules and cell division: Potential pharmacological targets in cancer therapy. Current Drug Targets, 24(11), 889–918. https://doi.org/10.2174/1389450124666230731094837
Sodhi, M., Yeung, S. N., Maberley, D., Mikelberg, F., & Etminan, M. (2022). Risk of ocular adverse events with taxane-based chemotherapy. JAMA Ophthalmology, 140(9), 880–884. https://doi.org/10.1001/jamaophthalmol.2022.3026
Soni, M., Walia, S., & Jain, P. (2023). Dry eye disease in head and neck cancer patients undergoing radiotherapy. Indian Journal of Ophthalmology, 71(4), 1556–1560.
Stjernschantz, J., & Astin, M. (2019). Anatomy and physiology of the eye. Physiological aspects of ocular drug therapy. In Biopharmaceutics of ocular drug delivery (pp. 1–25). CRC Press.
Stoicescu, E. A., Burcea, M., Iancu, R. C., Zivari, M., Popa Cherecheanu, A., Bujor, I. A., Rastoaca, C., & Iancu, G. (2021). Docetaxel for breast cancer treatment-side effects on ocular surface, a systematic review. Processes, 9(7), 1086. https://doi.org/10.3390/jcm9041086
Su, Z. Y., Siak, P. Y., Lwin, Y. Y., & Cheah, S.-C. (2024). Epidemiology of nasopharyngeal carcinoma: current insights and future outlook. Cancer and Metastasis Reviews, 43(3), 919–939. https://doi.org/10.1007/s10555-024-10176-9
Xie, W.-H., Xiao, W.-W., Chang, H., Xu, M.-J., Hu, Y.-H., Zhou, T.-C., Zhong, Q., Chen, C.-Y., Lu, L.-X., & Wang, Q.-X. (2025). Four cycles of docetaxel plus cisplatin as neoadjuvant chemotherapy followed by concurrent chemoradiotherapy in stage N2-3 nasopharyngeal carcinoma: phase 3 multicentre randomised controlled trial. Bmj, 389.
Yamagishi, T., Ochi, N., Yamane, H., Hasebe, S., & Takigawa, N. (2014). Epiphora in lung cancer patients receiving docetaxel: a case series. BMC Research Notes, 7(1), 322. https://doi.org/10.1186/1756-0500-7-322
Yao, Y., & Zhang, Y. (2017). The lacrimal gland: development, wound repair and regeneration. Biotechnology Letters, 39(7), 939–949. https://doi.org/10.1007/s10529-017-2326-1
Zuo, X.-Y., Feng, Q.-S., Sun, J., Wei, P.-P., Chin, Y.-M., Guo, Y.-M., Xia, Y.-F., Li, B., Xia, X.-J., & Jia, W.-H. (2019). X-chromosome association study reveals genetic susceptibility loci of nasopharyngeal carcinoma. Biology of Sex Differences, 10(1), 13. https://doi.org/10.1186/s13293-019-0227-9
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