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西妥昔单抗治疗相关输注反应的管理:一例报告。

Management of infusion reactions associated with cetuximab treatment: A case report.

作者信息

Ohshita Naohiro, Ichimaru Yuri, Gamoh Shoko, Tsuji Kaname, Kishimoto Naotaka, Tsutsumi Yasuo M, Momota Yoshihiro

机构信息

Department of Anesthesiology, Osaka Dental University, Osaka 540-0008, Japan.

Department of Oral Radiology, Osaka Dental University, Osaka 540-0008, Japan.

出版信息

Mol Clin Oncol. 2017 Jun;6(6):853-855. doi: 10.3892/mco.2017.1242. Epub 2017 May 5.

Abstract

Cetuximab is a drug targeting the epidermal growth factor receptor, which is indicated for the treatment of unresectable advanced or recurrent head and neck or colorectal cancer. Cetuximab also enhances the cytotoxic effects of radiation in squamous cell carcinoma. The severity of infusion reactions (IR) is categorized from grade 1 to 5; grades 3 and 4 are associated with life-threatening reactions (anaphylaxis), whereas grade 5 indicates death. The incidence of grade 3-4 IR with premedication is reported to be 1.1%. We herein describe a case of a 77-year-old man who developed IR during intravenous administration of cetuximab. The patient developed grade 3-4 anaphylaxis with pruritus, rash and urticaria, followed by hypotension and bradycardia. The timely diagnosis and treatment with intravenous infusion of a vasopressor drug and Ringer's acetate solution proved to be effective. The case presented herein demonstrated an unfeatured aspect of cetuximab-related IR as dermatological reactions over the entire body followed by circulatory collapse.

摘要

西妥昔单抗是一种靶向表皮生长因子受体的药物,适用于治疗无法切除的晚期或复发性头颈癌或结直肠癌。西妥昔单抗还可增强鳞状细胞癌放疗的细胞毒性作用。输注反应(IR)的严重程度分为1至5级;3级和4级与危及生命的反应(过敏反应)相关,而5级表示死亡。据报道,预防性用药后3-4级IR的发生率为1.1%。我们在此描述了一例77岁男性在静脉输注西妥昔单抗期间发生IR的病例。患者出现3-4级过敏反应,伴有瘙痒、皮疹和荨麻疹,随后出现低血压和心动过缓。静脉输注血管加压药和醋酸林格液的及时诊断和治疗被证明是有效的。本文介绍的病例展示了西妥昔单抗相关IR的一个未被关注的方面,即全身皮肤反应后出现循环衰竭。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb4f/5451859/8c9b4408a7aa/mco-06-06-0853-g00.jpg

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