Gadducci A, Tana R, Teti G, Zanca G, Fanucchi A, Genazzani A R
Department of Procreative Medicine, Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy.
Int J Gynecol Cancer. 2008 Jul-Aug;18(4):615-20. doi: 10.1111/j.1525-1438.2007.01063.x.
The aim of this paper was to assess hypersensitivity reactions in 69 patients who received carboplatin (CBDCA) retreatment for recurrent ovarian cancer. Hypersensitivity reactions developed in 15 (21.7%) patients and occurred during the second cycle of retreatment in 13 (86.7%) of them. Reactions consisted of skin rash, flushing, itching, or abdominal cramping in eight (53.3%) and severe respiratory or cardiovascular events in seven patients (46.7%). One patient had a chest pain, without any other symptoms suggestive of hypersensitivity, followed by cardiac arrest unresponsive to standard resuscitative measures. All the other cases promptly recovered from symptoms. Logistic regression analysis showed that allergy history and CBDCA retreatment interval (interval time between the last cycle of first-line chemotherapy and CBDCA retreatment) were independent predictive variables for the risk of hypersensitivity, whereas patient age, first-line chemotherapy, total CBDCA dose given during first-line treatment, recurrence treated with CBDCA (first versus other), and CBDCA regimen at recurrence had no predictive value. Hypersensitivity reaction rate was higher in patients with CBDCA retreatment interval longer than 23.4 months compared to those with a shorter interval (36.3% versus 8.3%, P = 0.0132). Nine patients were subsequently treated with cisplatin, and two (22.2%) still developed allergic reactions. In conclusion, hypersensitivity reactions to CBDCA retreatment can occur in approximately one fifth of the cases, and a CBDCA retreatment interval longer than 2 years appears to be the strongest predictive variable for the development of allergic reactions.
本文旨在评估69例接受卡铂（CBDCA）复治的复发性卵巢癌患者的过敏反应。15例（21.7%）患者发生了过敏反应，其中13例（86.7%）发生在复治的第二个周期。反应包括皮疹、潮红、瘙痒或腹部绞痛8例（53.3%），严重呼吸或心血管事件7例（46.7%）。1例患者出现胸痛，无任何其他提示过敏的症状，随后心脏骤停，对标准复苏措施无反应。所有其他病例症状迅速恢复。逻辑回归分析显示，过敏史和CBDCA复治间隔（一线化疗最后一个周期与CBDCA复治之间的间隔时间）是过敏风险的独立预测变量，而患者年龄、一线化疗、一线治疗期间给予的总CBDCA剂量、CBDCA治疗的复发情况（首次与其他情况）以及复发时的CBDCA方案均无预测价值。与间隔较短的患者相比，CBDCA复治间隔超过23.4个月的患者过敏反应发生率更高（36.3%对8.3%，P = 0.0132）。9例患者随后接受顺铂治疗，2例（22.2%）仍发生过敏反应。总之，CBDCA复治的过敏反应约五分之一的病例中会发生，且CBDCA复治间隔超过2年似乎是过敏反应发生的最强预测变量。
