Dizon Don S, Schwartz Joanna, Rojan Adam, Miller Jane, Pires Leslie, Disilvestro Paul, Gordinier Mary E, Moore Richard, Granai Cornelius O, Legare Robert D
Program in Women's Oncology and the Department of Pharmacy, Women and Infants' Hospital, 101 Dudley Street, Providence, RI 02905, USA.
Gynecol Oncol. 2006 Jan;100(1):149-51. doi: 10.1016/j.ygyno.2005.08.004. Epub 2005 Sep 28.
With the use of steroid premedication, the incidence of severe hypersensitivity reactions (S-HSR) to paclitaxel is estimated to be 2%. For those who develop a S-HSR to paclitaxel, docetaxel has been employed as an alternative agent though the presence of cross-sensitivity has not been established. We sought to define the incidence of S-HSR to docetaxel following a paclitaxel S-HSR in an academic women's cancer program.
Patients treated with either paclitaxel (P) or docetaxel (D) between 11/1999 and 8/2004 were identified through our pharmacy database. Records were reviewed and data collected on those patients who had a S-HSR, defined as symptoms for which drug was discontinued, to P, D, or both.
718 patients received P and 93 received D. 59 received D following treatment with P. The presence of S-HSR for P was 2.2% (16/718 patients) and for D was 9.7% (9/93 patients). 10 patients with S-HSR to P crossed over to D and all nine patients reacting to D had a prior reaction to T for a cross-sensitivity rate of 90% (9/10 patients).
Cross-sensitivity of D after P was 90% at our institution. Given the different vehicles used in P and D, it is likely attributed to the taxane moiety. Caution is required with re-challenge of patients with docetaxel if they have previously reacted to paclitaxel.
使用类固醇进行预处理后，对紫杉醇发生严重过敏反应（S-HSR）的发生率估计为2%。对于那些对紫杉醇发生S-HSR的患者，尽管尚未确定是否存在交叉敏感性，但多西他赛已被用作替代药物。我们试图在一个学术性的女性癌症项目中确定紫杉醇S-HSR后对多西他赛发生S-HSR的发生率。
通过我们的药房数据库识别1999年11月至2004年8月期间接受紫杉醇（P）或多西他赛（D）治疗的患者。回顾记录并收集那些对P、D或两者发生S-HSR（定义为因症状而停药）的患者的数据。
718例患者接受了P治疗，93例接受了D治疗。59例在接受P治疗后接受了D治疗。P的S-HSR发生率为2.2%（16/718例患者），D的发生率为9.7%（9/93例患者）。10例对P发生S-HSR的患者转而接受D治疗，所有9例对D有反应的患者之前对P都有反应，交叉敏感性率为90%（9/10例患者）。
在我们机构，P后D的交叉敏感性为90%。鉴于P和D使用的载体不同，这可能归因于紫杉烷部分。如果患者之前对紫杉醇有反应，再次使用多西他赛时需要谨慎。
