Wu Yi-Hong, Chen Hsing-Yu, Lai Chyong-Huey, Yeh Chein-Shuo, Pang Jong-Hwei S, Qiu Jian-Tai, Chou Hung-Hsueh, Yang Lan-Yan, Pan Yu-Bin
Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Evid Based Complement Alternat Med. 2018 Jul 12;2018:4201325. doi: 10.1155/2018/4201325. eCollection 2018.
Chemotherapy-induced thrombocytopenia (CIT) is a serious complication among patients with gynecological malignancies, yet management options are limited. This study aimed at reporting the potential of the Chang Gung platelet elevating formula (CGPEF), a prescription with a fixed proportion of Chinese herbs, for improving CIT among gynecologic cancer patients.
From 1/1/2007 to 31/12/2009, a total of 23 patients with two consecutive CIT episodes (≤ 100×10 /L) (last cycle: C0; index cycle: C1) received the CGPEF from the nadir of platelet count of C1 and through the subsequent chemotherapy cycles (C2 and beyond). The CGPEF was taken orally four times a day. The evolution of platelet counts of 18 patients after administration of CGPEF was analyzed (2 patients had different chemotherapy regimens after CGPEF, two patients discontinued CGPEF due to the flavor and the amount of CGPEF, and one patient had no further chemotherapy).
Most of the patients had recurrent ovarian cancer (11/18, 61%) with a median of 2.5 previous chemotherapy regimens, and carboplatin-based regimens were the most commonly used for these patients (13/18, 72%). The trend of successive CIT could be reversed after taking CGPEF. Also, the platelet nadir was higher after CGPEF treatment (16.5×10/L versus 32×10/L, before and after CGPEF treatment, resp., = 0.002). Moreover, the chemotherapy interval decreased from 30.5 days to 24 days. No thrombocytosis, clinical bleeding, thromboembolism, or other adverse events were found among these patients.
The CGPEF is worthy of further large-scale, well-designed clinical trials for CIT among gynecological cancer patients.
化疗引起的血小板减少症（CIT）是妇科恶性肿瘤患者的一种严重并发症，但治疗选择有限。本研究旨在报告长庚升血小板方（CGPEF），一种固定比例的中药方剂，在改善妇科癌症患者CIT方面的潜力。
从2007年1月1日至2009年12月31日，共有23例患者连续出现两次CIT发作（≤100×10⁹/L）（最后一个周期：C0；索引周期：C1），从C1血小板计数最低点开始并在随后的化疗周期（C2及以后）接受CGPEF治疗。CGPEF每天口服4次。分析了18例患者服用CGPEF后血小板计数的变化情况（2例患者在服用CGPEF后采用了不同的化疗方案，2例患者因CGPEF的味道和用量而停用，1例患者未再进行化疗）。
大多数患者患有复发性卵巢癌（11/18，61%），既往化疗方案中位数为2.5个，以卡铂为基础的方案是这些患者最常用的方案（13/18，72%）。服用CGPEF后，连续CIT的趋势可以逆转。此外，CGPEF治疗后血小板最低点更高（分别为16.5×10⁹/L和32×10⁹/L，CGPEF治疗前后，P = 0.002）。而且，化疗间隔从30.5天缩短至24天。这些患者中未发现血小板增多、临床出血、血栓栓塞或其他不良事件。
CGPEF值得在妇科癌症患者CIT方面进行进一步大规模、设计良好的临床试验。
