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结直肠癌患者中奥沙利铂诱导的超敏反应的危险因素。

Risk factors for oxaliplatin-induced hypersensitivity reaction in patients with colorectal cancer.

作者信息

Song Qiuyan, Cai Yuanxuan, Guo Kangyuan, Li Min, Yu Zaoqin, Tai Qirui, Zhao Yuhang, Zhu Xuan, Zhang Chengliang

机构信息

Department of Pharmacy, The Sixth Affiliated Hospital of Kunming Medical University Yuxi 653100, Yunnan, China.

School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, Hubei, China.

出版信息

Am J Transl Res. 2022 Apr 15;14(4):2461-2468. eCollection 2022.

Abstract

OBJECTIVE

Hypersensitivity reactions with oxaliplatin (OXA) have attracted much attention. This study aimed to analyze the risk factors for OXA-induced hypersensitivity reaction in Chinese colorectal cancer patients through a single-center retrospective investigation.

METHODS

The information from 459 colorectal cancer patients treated with OXA in a hospital was collected retrospectively to explore the risk factors for OXA-induced hypersensitivity reaction.

RESULTS

Among the 459 patients, 47 (10.24% incidence) cases developed hypersensitivity reactions, with a 3.70% incidence of grade III/IV reaction. The main symptoms included itching, flushing, dyspnea, and rash, which mainly involved skin and adnexa, respiratory system, and nervous system. Dexamethasone pretreatment presented no significant effects on the hypersensitivity reaction (P = 0.282). Multivariate analysis indicated that the previous allergic history (odds ratio (OR) 2.553, 95% confidence interval (CI) 1.139-5.721, P = 0.023) and OXA-free interval (OR 3.605, 95% CI 1.909-6.809, P = 0.000) were independent risk factors for OXA-induced hypersensitivity reaction.

CONCLUSIONS

The incidence of OXA-induced hypersensitivity reaction in colorectal cancer patients was similar to those reported in other countries. Clinical medical staff should pay close attention to high-risk factors, such as allergic history and patients having OXA-free intervals in order to avoid or alleviate hypersensitivity reactions.

摘要

目的

奥沙利铂(OXA)引起的过敏反应备受关注。本研究旨在通过单中心回顾性调查分析中国结直肠癌患者发生奥沙利铂诱导的过敏反应的危险因素。

方法

回顾性收集某医院459例接受奥沙利铂治疗的结直肠癌患者的信息,以探讨奥沙利铂诱导的过敏反应的危险因素。

结果

459例患者中,47例(发生率10.24%)发生过敏反应,Ⅲ/Ⅳ级反应发生率为3.70%。主要症状包括瘙痒、潮红、呼吸困难和皮疹,主要累及皮肤及附件、呼吸系统和神经系统。地塞米松预处理对过敏反应无显著影响(P = 0.282)。多因素分析表明,既往过敏史(比值比(OR)2.553,95%置信区间(CI)1.139 - 5.721,P = 0.023)和无奥沙利铂间期(OR 3.605,95% CI 1.909 - 6.809,P = 0.000)是奥沙利铂诱导的过敏反应的独立危险因素。

结论

结直肠癌患者中奥沙利铂诱导的过敏反应发生率与其他国家报道的相似。临床医务人员应密切关注过敏史和无奥沙利铂间期等高危因素,以避免或减轻过敏反应。

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