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寻找妇科盆腔肿瘤化疗中紫杉醇和铂盐过敏反应的预测因素。

A search for predictive factors for hypersensitivity reactions to paclitaxel and platinum salts in chemotherapy for gynecologic pelvic neoplasms.

机构信息

Department of Gynecologic Oncology, AO Mauriziano Umberto I, University of Turin,Turin, Italy.

出版信息

Gynecol Obstet Invest. 2012;74(1):21-7. doi: 10.1159/000336772. Epub 2012 May 31.

Abstract

AIMS

To investigate the frequency of and predictive factors for hypersensitivity reactions (HR) to taxanes and platinum salts in a cohort of patients treated for pelvic gynecologic malignancies.

METHODS

The medical records of all patients with gynecologic pelvic neoplasms treated with chemotherapy at the Department of Gynecologic Oncology, AO Mauriziano Umberto I of Turin, from September 2007 through August 2008, were retrospectively reviewed. Two multivariate models, regarding carboplatin and taxane chemotherapy, respectively, were performed to evaluate the potential predictive value of various clinical features.

RESULTS

The incidence of HR was 14% (22/157). Multivariate models showed that menopausal women had a significantly lower probability of HR (OR 0.12, CI 0.02-1.13, p = 0.06 for the carboplatin model and OR 0.05, CI 0.01-0.63, p = 0.02 for the taxane model) while a history of systemic hypersensitivity was associated with a higher but non-significant risk of HR (OR 2.64, CI 0.78-8.95, p = 0.11, for the carboplatin model and OR 3.42, CI 0.94-12.45, p = 0.06, for the taxane model).

CONCLUSION

We confirmed a history of hypersensitivity as a risk factor for HR. Other larger cohorts should be analyzed: we need to find new predictive factors in order to select women who should be submitted to experimental prophylactic strategies.

摘要

目的

调查在接受盆腔妇科恶性肿瘤治疗的患者队列中 taxanes 和铂类盐类药物过敏反应(HR)的发生频率和预测因素。

方法

回顾性分析 2007 年 9 月至 2008 年 8 月在都灵 AO Mauriziano Umberto I 妇科肿瘤学系接受化疗的所有妇科盆腔肿瘤患者的病历。分别针对卡铂和紫杉烷化疗进行了两个多变量模型,以评估各种临床特征的潜在预测价值。

结果

HR 的发生率为 14%(22/157)。多变量模型显示,绝经后妇女发生 HR 的概率显著降低(卡铂模型的 OR 为 0.12,95%CI 为 0.02-1.13,p = 0.06;紫杉烷模型的 OR 为 0.05,95%CI 为 0.01-0.63,p = 0.02),而全身性过敏史与更高但无统计学意义的 HR 风险相关(卡铂模型的 OR 为 2.64,95%CI 为 0.78-8.95,p = 0.11;紫杉烷模型的 OR 为 3.42,95%CI 为 0.94-12.45,p = 0.06)。

结论

我们证实过敏史是 HR 的危险因素。其他更大的队列应该进行分析:我们需要找到新的预测因素,以便选择应该接受实验性预防策略的女性。

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