Department of Pharmacy, Fudan University Shanghai Cancer Center, Shangai, 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Int J Clin Oncol. 2021 Dec;26(12):2194-2204. doi: 10.1007/s10147-021-02034-3. Epub 2021 Oct 9.
This study aimed to investigate risk factors associated with oxaliplatin hypersensitivity reactions in cancer patients through a meta-analysis. A comprehensive retrieve of Chinese databases China National Knowledge Infrastructure, Wanfang Data, VIP Database and English databases PubMed, ScienceDirect, Embase and Cochrane library was conducted. The studies that meet the requirements for meta-analysis according to inclusion and exclusion criteria were screened and assessed for eligibility. Odds ratio (OR) / Weighted mean difference (WMD) and 95% confidence intervals (95% CIs) or calculable dichotomous and continuous raw data were extracted to perform meta-analysis using random effect model or fixed effect model on the basis of heterogeneity between studies through Review Manager 5.4 software. A total of 14 cross-sectional studies and 3367 cancer patients were included. Meta-analysis results showed that platinum exposure history (OR value 3.13, 95% CI 2.19-4.48, heterogeneity P = 0.26), allergy history (OR value 1.76, 95% CI 1.09-2.85, heterogeneity P = 0.61), platinum free interval (OR value 3.75, 95% CI 2.00-7.06, heterogeneity P = 0.83), dexamethasone premedication dose (OR value 0.28, 95% CI 0.13-0.58, heterogeneity P = 0.21) were significantly correlated to oxaliplatin hypersensitivity reactions. Gender, age, metastasis, combination with bevacizumab, XELOX regimen and cancer types were detected to have no statistically significant effect on oxaliplatin hypersensitivity reactions. Platinum exposure history, allergy history and long platinum-free interval are risk factors of oxaliplatin hypersensitivity reactions. High dexamethasone premedication dose is a protective factor of oxaliplatin hypersensitivity reactions.
本研究通过荟萃分析旨在探讨癌症患者奥沙利铂过敏反应的相关危险因素。通过全面检索中文数据库中国知识基础设施（CNKI）、万方数据、维普数据库和英文数据库 PubMed、ScienceDirect、Embase 和 Cochrane 图书馆，筛选出符合纳入和排除标准的研究，并评估其纳入标准的适用性。使用 Review Manager 5.4 软件，根据研究之间的异质性，采用随机效应模型或固定效应模型，提取比值比（OR）/加权均数差（WMD）和 95%置信区间（95%CI）或可计算的二分类和连续原始数据，进行荟萃分析。共纳入 14 项横断面研究和 3367 例癌症患者。荟萃分析结果显示，铂类药物暴露史（OR 值 3.13，95%CI 2.19-4.48，异质性 P=0.26）、过敏史（OR 值 1.76，95%CI 1.09-2.85，异质性 P=0.61）、铂类药物无暴露间隔（OR 值 3.75，95%CI 2.00-7.06，异质性 P=0.83）、地塞米松预处理剂量（OR 值 0.28，95%CI 0.13-0.58，异质性 P=0.21）与奥沙利铂过敏反应显著相关。性别、年龄、转移、联合贝伐珠单抗、XELOX 方案和癌症类型对奥沙利铂过敏反应无统计学意义。铂类药物暴露史、过敏史和较长的铂类药物无暴露间隔是奥沙利铂过敏反应的危险因素。高剂量地塞米松预处理是奥沙利铂过敏反应的保护因素。
