• 医学文献
  • 知识库
  • 评价分析
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
  • 临床诊疗知识库
  • 中医药知识库
  • 机构
  • 作者
热搜词:
换一批
论文 期刊
取消
高级检索

检索历史 清除

医学文献 >>
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
知识库 >>
  • 临床诊疗知识库
  • 中医药知识库
评价分析 >>
  • 机构
  • 作者
热搜词:
换一批

卵巢上皮性癌和子宫颈癌患者铂类药物超敏反应的临床分析

Clinical analysis of hypersensitivity reaction of platinum in ovarian cancer and cervical cancer patients

摘要:

目的探讨卵巢上皮性癌(卵巢癌)和子宫颈癌发生铂类药物超敏反应(HSR)患者的临床特点及相关影响因素。方法收集2013年1月至2016年1月间中国医学科学院北京协和医院因卵巢癌接受卡铂+紫杉醇3周疗方案(860例)或子宫颈癌接受放疗+顺铂(顺铂为周疗)的同步放化疗(580例)患者的资料,总结HSR的发生率、分级、常见症状、后续处理方案,分析影响HSR发生及患者预后的相关因素。结果(1)HSR的发生率:860例卵巢癌患者中,8.8%(76/860)的患者发生卡铂HSR;580例子宫颈癌患者中,5.9%(34/580)的患者发生顺铂HSR。(2)HSR的分级:卵巢癌、子宫颈癌患者均以1~2级HSR为主,分别占78.9%(60/76)、82.4%(28/34),其中1级HSR分别为7、11例,2级HSR分别为53、17例。(3)HSR的常见症状:卵巢癌、子宫颈癌患者的铂类药物HSR多发生在静脉输注铂类药物的过程中,分别占98.7%(75/76)、97.1%(33/34)。最常见症状为胸闷气短,分别占92.1%(70/76)、97.1%(33/34);其次为皮肤症状,分别占53.9%(41/76)、88.2%(30/34)。(4)HSR的后续治疗方案:76例发生卡铂HSR的卵巢癌患者中,4例继续应用原方案化疗的患者中1例(1/4)、13例接受脱敏治疗的患者中4例(4/13)、11例接受化疗药物分开使用的患者中3例(3/11)、11例换用顺铂的患者中2例(2/11)再次发生HSR,其余37例患者换用非铂类药物化疗(6例)或终止化疗(31例),接受不同后续治疗方案的卵巢癌患者再次发生HSR的比例比较无明显差异(χ2=0.517,P=0.915)。34例发生顺铂HSR的子宫颈癌患者中,9例继续应用顺铂周疗的患者中2例(2/9)、17例接受脱敏治疗的患者中3例(3/17)再次发生HSR,其余8例患者换用紫杉醇化疗(5例)或终止化疗(3例),接受不同后续治疗方案的子宫颈癌患者再次发生HSR的比例比较无明显差异(χ2=0.079,P=1.000)。(5)影响HSR发生及发生HSR患者预后的相关因素:卵巢癌患者发生HSR的危险因素包括复发患者所占比例(P=0.010)、化疗疗程数(初治患者达到7个或9个疗程,复发患者达到6个或7个疗程;P<0.05)。子宫颈癌患者中未发现影响HSR发生的高危因素(P>0.05)。HSR并不影响卵巢癌和子宫颈癌患者的无复发生存时间(P=0.144,P=0.782)。结论卵巢癌、子宫颈癌患者铂类药物HSR的症状轻微、结局良好;复发患者所占比例以及化疗疗程数是影响卵巢癌患者卡铂HSR发生的高危因素。

更多
abstracts:

Objective To investigate the incidence, risk factors, management and prognosis of hypersensitivity reaction (HSR) of platinum-based chemotherapy in patients of ovarian cancer and cervical cancer. Methods Cases from Peking Union Medical College Hospital from Jan. 2013 to Jan. 2016 were checked for patients′ data of epithelial ovarian cancer treated with carboplatin/paclitaxel (every 3 weeks) and patients of cervical cancer treated with concurrent radiochemotherapy using cisplatin (every week). General characters, pathological features, treatment and prognosis of patients were analyzed to determine the severity, symptoms, outcomes and risk factors of HSR. Results (1)Prevalence of HSR: there were 860&nbsp;cases of ovarian cancer and 580 cases of cervical cancer, among which HSR occurred in 8.8%(76/860) and 5.9%(34/580) patients, respectively.(2)Grading for HSR:most HSR were grade 1 or 2, with 78.9%(60/76) in ovarian cancer and 82.4%(28/34) in cervical cancer patients. In ovarian cancer patients, there were 7 cases of grade 1 HSR and 53 cases of grade 2 HSR, and in cervical cancer patients, there were 11 cases of grade 1 HSR and 17 cases of grade 2 HSR.(3)Symptoms of HSR:most of HSR happened during intravenous infusion of platinum agents, with 98.7%(75/76) in ovarian cancer and 97.1%(33/34) in cervical cancer patients. In ovarian and cervical cancer patients, most common symptom were tight chest and dyspnea, which happened in 92.1%(70/76) and 97.1%(33/34) patients, respectively. Secondary common symptom were skin reactions, which happened in 53.9% (41/76) and 88.2% (30/34) patients respectively.(4)Treatment after HSR: of 76 ovarian cancer cases with HSR, there were no significant difference in the ratio of HSR recurrence among patients of different treatment after HSR (χ2=0.517, P=0.915):1 of 4 patients applying prior chemotherapy, 4 of 13 cases receiving desensitization, 3 of 11 cases separating medicine, 2 of 11 patients switching to cisplatin. In 34 cervical cancer cases of HSR, there were also no significant difference in the ratio of HSR recurrence among patients of different treatment after HSR (χ2=0.079, P=1.000): 2 of 9 patients applying prior chemotherapy, 3 of 17 cases receiving desensitization.(5)Risk factors of HSR and patients prognosis:in ovarian cancer patients of HSR, risk factors included relapse (P=0.010), courses of chemotherapy reaching seven or nine for patients of primary treatment or reaching six or seven for recurrent patients (all P<0.05). There were no significant risk factors for cervical cancer patients of HSR (all P>0.05). HSR had no impact on the progression- free survival for ovarian cancer (P=0.144) or cervical cancer (P=0.782). Conclusions In ovarian cancer patients treated with carboplatin and cervical cancer patients treated with concurrent radiochemotherapy using cisplatin, most HSR of platinum are mild and favorable outcomes. Relapse and longer chemotherapy courses are risk factors for HSR of carboplatin for epithelial ovarian cancer.

More
  • 浏览:555
  • 下载:317

加载中!

相似文献

  • 中文期刊
  • 外文期刊
  • 学位论文
  • 会议论文

加载中!

加载中!

加载中!

加载中!

扩展文献

特别提示:本网站仅提供医学学术资源服务,不销售任何药品和器械,有关药品和器械的销售信息,请查阅其他网站。

  • 客服热线:4000-115-888 转3 (周一至周五:8:00至17:00)

  • |
  • 客服邮箱:yiyao@wanfangdata.com.cn

  • 违法和不良信息举报电话:4000-115-888,举报邮箱:problem@wanfangdata.com.cn,举报专区

官方微信
万方医学小程序
new翻译 充值 订阅 收藏 移动端

官方微信

万方医学小程序

使用
帮助
Alternate Text
调查问卷