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针对接受癌症化疗患者毒性改善的药物模式及影响

Pattern and impact of drugs targeted toward toxicity amelioration in patients receiving cancer chemotherapy.

作者信息

Singh Shruti, Singh Prashant Kumar

机构信息

Department of Pharmacology, AIIMS, Patna, Bihar, India.

Department of Surgery, AIIMS, Patna, Bihar, India.

出版信息

Perspect Clin Res. 2018 Jan-Mar;9(1):23-30. doi: 10.4103/picr.PICR_156_16.

Abstract

BACKGROUND

Drug therapy today is remarkably safe and efficacious. Still, some drugs - particularly anticancer drugs - are fraught with numerous adverse drug reactions (ADRs), severely jeopardizing quality of life of cancer patients. Fortunately, most of these ADRs are preventable provided adequate prophylactic drugs are administered along with chemotherapy.

AIMS

The aim of this study is to assess the pattern and impact of cytoprotective prophylactic drugs on anticancer ADRs in patients receiving cancer chemotherapy.

SUBJECTS AND METHODS

We included 200 patients receiving anticancer therapy for the first time. Patient details and for each cycle: details of baseline investigations, anticancer treatment given, ADRs observed and interventions done to prevent and manage the ADRs were recorded. Preventability and predictability scales were applied to assess the impact of drugs and strategies toward toxicity amelioration. Data were analyzed using descriptive statistics.

RESULTS

Adjuvant drugs were administered prophylactically along with anticancer drugs for the prevention of nausea and vomiting, gastritis, immediate allergic reactions, nephrotoxicity, ototoxicity, hemorrhagic cystitis, and other anticipated ADRs. About 94.80% reactions were found to be predictable and 5.20% unpredictable. Maximum reactions (56.47%) were probably preventable. Paracetamol, filgrastim, mucaine, etc., were used to manage a variety of ADRs.

CONCLUSIONS

Although the predictability of ADRs was almost 95%, we could prevent only about 56% of them. Surprisingly, we have no ADRs that appear definitely preventable. This could be due to less attention being paid to the ADRs that could have been prevented by the appropriate use of prophylactic measures.

摘要

背景

如今的药物治疗安全性高且疗效显著。然而,一些药物——尤其是抗癌药物——存在众多药物不良反应(ADR),严重危及癌症患者的生活质量。幸运的是,若在化疗的同时使用足够的预防性药物,这些不良反应大多是可预防的。

目的

本研究旨在评估细胞保护预防性药物对接受癌症化疗患者的抗癌药物不良反应的模式及影响。

对象与方法

我们纳入了200例首次接受抗癌治疗的患者。记录患者详细信息以及每个周期的情况:基线检查细节、给予的抗癌治疗、观察到的药物不良反应以及为预防和处理这些不良反应所采取的干预措施。应用可预防性和可预测性量表来评估药物及减轻毒性策略的影响。采用描述性统计方法对数据进行分析。

结果

预防性地将辅助药物与抗癌药物同时使用,以预防恶心呕吐、胃炎、即刻过敏反应、肾毒性、耳毒性、出血性膀胱炎及其他预期的药物不良反应。约94.80%的反应是可预测的,5.20%是不可预测的。最大比例的反应(56.47%)可能是可预防的。对乙酰氨基酚、非格司亭、黏膜保护剂等被用于处理各种药物不良反应。

结论

尽管药物不良反应的可预测性接近95%,但我们仅能预防其中约56%的反应。令人惊讶的是,我们没有明确可预防的药物不良反应。这可能是由于对通过适当使用预防措施本可预防的药物不良反应关注较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6039/5799948/f7ec95eae178/PCR-9-23-g004.jpg

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