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基于中国东部地区实体瘤抗肿瘤药物的化疗诱导性血小板减少症风险预测模型。

The predictive model for risk of chemotherapy-induced thrombocytopenia based on antineoplastic drugs for solid tumors in eastern China.

机构信息

Department of Medical Oncology, Jinhua Hospital, Zhejiang University School of Medicine, 351 Mingyue Road, Jinhua, 321000, Zhejiang Province, China.

Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, Zhejiang Province, China.

出版信息

Sci Rep. 2023 Feb 23;13(1):3185. doi: 10.1038/s41598-023-27824-9.

DOI:10.1038/s41598-023-27824-9
PMID:36823199
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9950128/
Abstract

Chemotherapy-related thrombocytopenia (CIT) is a significant adverse event during chemotherapy, which can lead to reduced relative dose intensity, increased risk of serious bleeding and additional medical expenditure. Herein, we aimed to develop and validate a predictive nomogram model for prediction of CIT in patients with solid tumor. From Jun 1, 2018 to Sep 9, 2021, a total of 1541 patients who received 5750 cycles of chemotherapy were retrospectively enrolled. Cox regression analysis was performed to identify predictive factors to establish the nomogram model for CIT. The incidence of chemotherapy-induced thrombocytopenia was 21.03% for patient-based and 10.26% for cycles of chemotherapy. The top five solid tumors with CIT are cervix, gastric, bladder, biliary systemic, and ovarian. The incidence of chemotherapy dose delays in any cycle because of CIT was 5.39%. Multivariate analysis showed that tumor site, treatment line, AST, oxaliplatin, and capecitabine were significantly associated with CIT. Moreover, we established a nomogram model for CIT probability prediction, and the model was well calibrated (Hosme-Lemeshow P = 0.230) and the area under the receiver operating characteristic curve was 0.844 (Sensitivity was 0.625, Specificity was 0.901). We developed a predictive model for chemotherapy-induced thrombocytopenia based on readily available and easily assessable clinical characteristics. The predictive model based on clinical and laboratory indices represents a promising tool in the prediction of CIT, which might complement the clinical management of thrombocytopenia.

摘要

化疗相关性血小板减少症(CIT)是化疗过程中的一种严重不良反应,可导致相对剂量强度降低、严重出血风险增加和额外的医疗支出。本研究旨在建立并验证一个预测实体瘤患者 CIT 的列线图模型。2018 年 6 月 1 日至 2021 年 9 月 9 日,共回顾性纳入 1541 例接受 5750 个化疗周期的患者。采用 Cox 回归分析确定预测因素,建立 CIT 的列线图模型。基于患者的 CIT 发生率为 21.03%,基于化疗周期的 CIT 发生率为 10.26%。CIT 发生率排名前五的实体瘤依次为宫颈癌、胃癌、膀胱癌、胆道系统癌和卵巢癌。因 CIT 而导致任何周期化疗剂量延迟的发生率为 5.39%。多变量分析显示,肿瘤部位、治疗线数、AST、奥沙利铂和卡培他滨与 CIT 显著相关。此外,我们建立了 CIT 概率预测的列线图模型,该模型具有良好的校准度(Hosme-Lemeshow P=0.230),ROC 曲线下面积为 0.844(灵敏度为 0.625,特异性为 0.901)。我们基于可获得和易于评估的临床特征建立了预测化疗相关性血小板减少症的模型。该基于临床和实验室指标的预测模型是预测 CIT 的一种有前途的工具,可能会补充血小板减少症的临床管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/1dcf22ff0c61/41598_2023_27824_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/ab8227ce382b/41598_2023_27824_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/2ed30ec2e24e/41598_2023_27824_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/f79f9dc12e8d/41598_2023_27824_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/1d68a0fd9ee4/41598_2023_27824_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/0e742d7f98b8/41598_2023_27824_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/1dcf22ff0c61/41598_2023_27824_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/ab8227ce382b/41598_2023_27824_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/2ed30ec2e24e/41598_2023_27824_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/f79f9dc12e8d/41598_2023_27824_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/1d68a0fd9ee4/41598_2023_27824_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/0e742d7f98b8/41598_2023_27824_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d57/9950128/1dcf22ff0c61/41598_2023_27824_Fig6_HTML.jpg

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