Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China.
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
Int J Gynecol Cancer. 2019 Mar;29(3):566-571. doi: 10.1136/ijgc-2018-000072. Epub 2018 Dec 22.
The prevalence and risk factors of hypersensitivity reaction of in patients with epithelial ovarian cancer treated with platinum are controversial.
To summarize the clinical characteristics and management of hypersensitivity reaction of carboplatin in patients with epithelial ovarian cancer and to determine its effects on prognoses.
Patients with epithelial ovarian cancer between January 2013 and January 2016 were identified. Data were retrospectively collected by reviewing the medical records of a single tertiary teaching hospital. Patients' demographic characteristics, symptoms, and treatment were described and compared between the hypersensitivity reaction and non-hypersensitivity reaction groups. The effects of hypersensitivity reaction on survival outcomes were analyzed in univariate and multivariate models.
A total of 860 patients were identified, including 76 (8.8%) patients with 86 incidents of hypersensitivity reaction in 5807 courses of chemotherapy. Of all patients with a first attack of hypersensitivity reaction, 79% were classified as grade 1-2. The most common symptoms were shortness of breath and tightness in the chest (70/76 cases, 92.1%). Subsequent management included chemotherapy suspension, switching to a non-platinum regimen, desensitization therapy, separated infusion of drugs, adherence to the original therapy, and switching to cisplatin. However, there was no significant difference in the proportion of patients with recurring hypersensitivity reaction among patients treated with different management methods (p=0.915). Disease relapse and chemotherapy courses ≥6 for primary epithelial ovarian cancer or ≥7 for recurrent disease were risk factors for platinum-based hypersensitivity reaction. There were no significant differences in median progression-free survival between the hypersensitivity reaction group and the non-hypersensitivity reaction group (p=0.144).
Most patients with epithelial ovarian cancer with a carboplatin-induced hypersensitivity reaction had mild symptoms and favorable outcomes, and their progression-free survival was not influenced. Disease relapse and the number of courses of chemotherapy were risk factors for a hypersensitivity reaction.
NCT03291262.
铂类药物治疗上皮性卵巢癌患者过敏反应的发生率和危险因素存在争议。
总结上皮性卵巢癌患者卡铂过敏反应的临床特征和处理方法，并确定其对预后的影响。
回顾性分析 2013 年 1 月至 2016 年 1 月于我院接受治疗的上皮性卵巢癌患者的病历资料，筛选出卡铂过敏反应患者，描述并比较过敏反应组和非过敏反应组患者的人口统计学特征、症状和治疗方法。采用单因素和多因素模型分析过敏反应对生存结局的影响。
共纳入 860 例患者，其中 76 例（8.8%）患者在 5807 个化疗周期中发生了 86 次过敏反应。所有首次出现过敏反应的患者中，79%为 1-2 级。最常见的症状为呼吸急促和胸闷（70/76 例，92.1%）。后续管理措施包括化疗暂停、更换非铂类方案、脱敏治疗、药物分开输注、坚持原方案、更换顺铂。但不同处理方式的患者中，过敏反应再发的比例无显著差异（p=0.915）。上皮性卵巢癌初治时疾病复发和化疗周期≥6 个、复发时化疗周期≥7 个是发生铂类过敏反应的危险因素。过敏反应组和非过敏反应组患者的中位无进展生存期无显著差异（p=0.144）。
上皮性卵巢癌患者卡铂过敏反应以轻度症状为主，结局良好，且无进展生存期不受影响。疾病复发和化疗周期数是过敏反应的危险因素。
NCT03291262。
