Rose Peter G, Fusco Nancy, Smrekar Mary, Mossbruger Kim, Rodriguez Michael
Case Western Reserve University, Ireland Cancer Center, Cleveland, OH 44106, USA.
Gynecol Oncol. 2003 Jun;89(3):429-33. doi: 10.1016/s0090-8258(03)00178-1.
The goal of this study was to evaluate the tolerance and effectiveness of carboplatin rechallenge using a prolonged desensitizing carboplatin infusion regimen in patients with clinically documented moderate-severe carboplatin hypersensitivity.
Patients admitted for carboplatin infusion were identified by computerized pharmacy records and retrospectively analyzed.
Thirty-three patients with recurrent ovarian (N = 27), peritoneal (N = 4), tubal (N = 1), and cervical (N = 1) cancer treated with a prolonged desensitizing carboplatin infusion regimen were identified. The patients had received a median of 10 courses of carboplatin (range 3-33) before developing the moderate-severe hypersensitivity reaction. Two hundred and fifteen courses (median 5, range 1-52) were administered. Twenty-nine patients (88%) were successfully rechallenged while four had a recurrent moderate-severe carboplatin hypersensitivity precluding further administration. Despite initial tolerance of the infusion schedule moderate-severe carboplatin hypersensitivity recurred in 3 additional patients (9%) after two, three, and six subsequent courses. Objective responses to therapy were seen in 22 of 28 evaluable patients (79%).
A prolonged desensitizing carboplatin infusion regimen is tolerated in the majority of patients with clinically documented moderate-severe carboplatin hypersensitivity. Objective response rates seem acceptable with this schedule.
本研究的目的是评估在临床记录有中度至重度卡铂超敏反应的患者中,使用延长的卡铂脱敏输注方案进行卡铂再激发的耐受性和有效性。
通过计算机药房记录识别接受卡铂输注的患者,并进行回顾性分析。
确定了33例接受延长的卡铂脱敏输注方案治疗的复发性卵巢癌(n = 27)、腹膜癌(n = 4)、输卵管癌(n = 1)和宫颈癌(n = 1)患者。这些患者在出现中度至重度超敏反应之前,接受卡铂治疗的中位数为10个疗程(范围3 - 33)。共进行了215个疗程(中位数5,范围1 - 52)的治疗。29例患者(88%)成功进行了再激发,而4例患者出现复发性中度至重度卡铂超敏反应,无法进一步给药。尽管最初对输注方案耐受,但在随后的2个、3个和6个疗程后,又有3例患者(9%)出现了中度至重度卡铂超敏反应复发。28例可评估患者中有22例(79%)出现了客观治疗反应。
大多数临床记录有中度至重度卡铂超敏反应的患者能够耐受延长的卡铂脱敏输注方案。该方案的客观缓解率似乎是可以接受的。