CAJ | 학술논문

背景与目的:奥沙利铂是晚期结直肠癌化疗的有效药物之一.已有国外学者总结和分析欧美人群使用奥沙利铂后出现过敏反应的情况,但在国内仅有一些个案报道.本研究旨在分析中国结直肠癌患者使用奥沙利铂后出现过敏反应的情况和特点.方法:回顾性收集109例一线采用奥沙利铂+卡培他滨(XELOX方案)化疗的转移复发结直肠癌患者的临床资料,分析奥沙利铂过敏反应的发生情况.结果:在109例接受XELOX方案化疗的患者中,13例(11.9%)发生过敏反应;109例患者化疗总疗程数是546,其中23个疗程(4.2%)出现过敏.在23次过敏反应中,Ⅰ度13次(56.5%),Ⅱ度8次(34.8%),Ⅲ度2次(8.7%),没有Ⅳ度过敏反应发生.发生奥沙利铂过敏反应的中位疗程数为第5疗程,出现过敏反应时患者已接受的奥沙利铂的中位累积剂量为1 200mg(400～1 600 mg).过敏反应在奥沙利铂滴注开始后5～360 min发生.中位时间180 min,经过停药、对症处理和抗过敏治疗后全部缓解.其中8例患者在后续治疗中应用奥沙利铂前,使用5-羟色胺受体Ⅰ阻断剂和糖皮质激素等抗过敏药物,4例未再出现过敏反应.女性较男性更易对奥沙利铂过敏(P<0.05),而发生过敏的患者和无过敏的患者在年龄、体表面积、体力状况、肿瘤部位、病理类型方面无明显差异.结论:中国结直肠癌患者使用奥沙利铂化疗时会出现过敏反应,其发生率、发生时间、严重程度、临床转归与国外文献报道基本相似.
배경여목적:오사리박시만기결직장암화료적유효약물지일.이유국외학자총결화분석구미인군사용오사리박후출현과민반응적정황,단재국내부유일사개안보도.본연구지재분석중국결직장암환자사용오사리박후출현과민반응적정황화특점.방법:회고성수집109례일선채용오사리박+잡배타빈(XELOX방안)화료적전이복발결직장암환자적림상자료,분석오사리박과민반응적발생정황.결과:재109례접수XELOX방안화료적환자중,13례(11.9%)발생과민반응;109례환자화료총료정수시546,기중23개료정(4.2%)출현과민.재23차과민반응중,Ⅰ도13차(56.5%),Ⅱ도8차(34.8%),Ⅲ도2차(8.7%),몰유Ⅳ도과민반응발생.발생오사리박과민반응적중위료정수위제5료정,출현과민반응시환자이접수적오사리박적중위루적제량위1 200mg(400～1 600 mg).과민반응재오사리박적주개시후5～360 min발생.중위시간180 min,경과정약、대증처리화항과민치료후전부완해.기중8례환자재후속치료중응용오사리박전,사용5-간색알수체Ⅰ조단제화당피질격소등항과민약물,4례미재출현과민반응.녀성교남성경역대오사리박과민(P<0.05),이발생과민적환자화무과민적환자재년령、체표면적、체력상황、종류부위、병리류형방면무명현차이.결론:중국결직장암환자사용오사리박화료시회출현과민반응,기발생솔、발생시간、엄중정도、림상전귀여국외문헌보도기본상사.
Background and Objective:Oxaliplatin is one of the effective drugs for the treatment of advanced colorectal cancer (CRC).Oxaliplatin-induced allergic reactions in European and American patients have been reported but in China there are only a few case reports.This study was to investigate the incidence rate and characteristics of oxaliplatin-induced allergic reactions in Chinese CRC patients.Methods:Clinical data of 109 advanced CRC patients receiving oxaliplatin plus capecitabine (XELOX regimen) as first-line therapy were collected and analyzed retrospectively.Results:Of 109 patients,13 (11.9%) had hypersensitivity.Of 546 cycles,23 (4.2%) had hypersensitivity.Grade-Ⅰ ,-Ⅱ ,and -Ⅲ reactions were seen in 13,8,and 2 cycles,respectively; no Grade-Ⅳ reaction was observed.Allergic reactions usually occurred in the median time of fifth cycle (range,1-8 cycles) of oxaliplatin-containing therapy,and the cumulative dose of oxaliplatin was 1200 mg (range,400-1600 mg).The symptoms associated with anaphylaxis appeared between 5 min and 360 min (median,180 min) after oxaliplatin infusion,and were relieved after withdrawal of the oxaliplatin infusion and treatment with antiallergic drugs.Eight patients continued to receive oxaliplatin therapy after prophylactically treatment with the antiallergic drugs,such as steroids,and 4 patients among them didn't suffer from allergic reactions any more.Oxaliplatin-induced allergic reactions were more commonly seen in female patients than in male patients (P<0.05).Age,body surface area,performance status,tumor location,and pathologic type showed no significant difference in the patients with different allergic reaction.Conclusions:Oxaliplatin-induced allergic reactions also occurred in Chinese colorectal cancer patients,and the incidence rate,occurrence time,degree of severity,and clinical outcome were coincident with abroad literatures.