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[目的]研究结直肠癌患者使用奥沙利铂后出现过敏反应的特点,分析结直肠癌患者发生过敏反应的危险因素.[方法]回顾性收集139例采用奥沙利铂化疗的结直肠癌患者的临床资料,分析奥沙利铂过敏反应的发生特征及危险因素.[结果] 139例结直肠癌患者接受奥沙利铂静脉化疗,14例(10.07%)患者发生过敏反应.过敏反应以一般症状和皮肤症状多见,主要表现为颜面潮红、皮疹、胸闷气急、心悸等.Logistic回归分析显示接受奥沙利铂姑息化疗的患者更容易发生过敏反应(OR=5.186,95% CI:1.240~21.697).化疗次数大于6次的患者较化疗次数≤6次的患者发生过敏反应的风险增高(OR=4.130,95%CI:1.132~15.073).[结论]10.07%的接受奥沙利铂化疗的结直肠癌患者发生过敏反应,过敏反应症状一般较轻,主要表现为皮肤潮红和皮疹.接受奥沙利铂化疗次数6次以上及以姑息化疗为目的的患者较容易发生过敏反应. 相似文献
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中国结直肠癌患者奥沙利铂过敏反应的临床特征 总被引:6,自引:0,他引:6
背景与目的:奥沙利铂是晚期结直肠癌化疗的有效药物之一。已有国外学者总结和分析欧美人群使用奥沙利铂后出现过敏反应的情况,但在国内仅有一些个案报道。本研究旨在分析中国结直肠癌患者使用奥沙利铂后出现过敏反应的情况和特点。方法:回顾性收集109例一线采用奥沙利铂+卡培他滨(XELOX方案)化疗的转移复发结直肠癌患者的临床资料,分析奥沙利铂过敏反应的发生情况。结果:在109例接受XELOX方案化疗的患者中,13例(11.9%)发生过敏反应;109例患者化疗总疗程数是546,其中23个疗程(4.2%)出现过敏。在23次过敏反应中,Ⅰ度13次(56.5%),Ⅱ度8次(34.8%),Ⅲ度2次(8.7%),没有Ⅳ度过敏反应发生。发生奥沙利铂过敏反应的中位疗程数为第5疗程,出现过敏反应时患者已接受的奥沙利铂的中位累积剂量为1200mg(400~1600mg)。过敏反应在奥沙利铂滴注开始后5~360min发生,中位时间180min,经过停药、对症处理和抗过敏治疗后全部缓解。其中8例患者在后续治疗中应用奥沙利铂前,使用5-羟色胺受体Ⅰ阻断剂和糖皮质激素等抗过敏药物,4例未再出现过敏反应。女性较男性更易对奥沙利铂过敏(P<0.05),... 相似文献
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目的 探究含奥沙利铂方案与FOLFIRI方案对Ⅳ期结直肠癌化疗疗效及预后影响的差别与K-ras基因状态的关系。方法 收集2010年1月至2012年1月的118例接受含奥沙利铂方案或FOLFIRI方案化疗的Ⅳ期结直肠癌患者临床资料,统计患者的治疗有效率(ORR)、疾病控制率(DCR)、无进展生存时间(PFS)和总生存期(OS)。采用χ2检验比较各组临床因素差别和两种治疗方案的有效率及疾病控制率,采用Kaplan-Meier法比较无进展生存时间以及总生存期。结果 118例患者中,接受含奥沙利铂方案化疗的K-ras突变型患者PFS及OS较接受FOLFIRI方案化疗患者延长(P=0.048;P=0.037),ORR及DCR较接受FOLFIRI方案化疗患者无明显差别(P=0.961;P=0.931)。接受含奥沙利铂方案化疗的K-ras野生型患者ORR、DCR、PFS及OS较接受FOLFIRI方案化疗患者无明显差别(P=0.900;P=0.802;P=0.738;P=0.904)。结论 采用含奥沙利铂方案一线化疗较FOLFIRI方案对K-ras突变型Ⅳ期结直肠癌患者更有优势,而对于K-ras野生型Ⅳ期结直肠癌患者,含奥沙利铂方案与FOLFIRI方案疗效及预后情况相当。 相似文献
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目的:探讨运用抗过敏药物预处理、奥沙利铂减慢速率输注或脱敏治疗进行奥沙利铂再化疗的可能性。尝试对奥沙利铂过敏的患者进行3个浓度梯度的皮试,同时分析奥沙利铂皮试结果与临床奥沙利铂过敏的符合率,了解皮试结果与临床奥沙利铂过敏的符合率。方法:对在本中心接受含奥沙利铂方案治疗的患者进行筛选,经临床医师根据临床症状和体征判断为奥沙利铂Ⅰ-Ⅲ度过敏反应的患者进入本研究。对Ⅰ-Ⅲ度奥沙利铂过敏的患者进行3个浓度梯度(0.01 mg/ml、0.1 mg/ml和5 mg/ml)的奥沙利铂皮试,并以5%葡萄糖水作为阴性对照。15~20分钟读取测试结果。如果皮疹最大径大于阴性对照3 mm判为阳性结果。之后根据奥沙利铂过敏反应的等级进行不同方式的干预措施。主要研究终点为奥沙利铂再次化疗3周期的完成率,次要终点为奥沙利铂皮试结果与临床医师判断之间的符合率。结果:2016年6月至2017年4月126例在本中心接受含奥沙利铂方案治疗的患者中,14例(11.1%)发生奥沙利铂过敏。发生奥沙利铂过敏反应的中位疗程数为第8疗程,过敏反应时患者已接受的奥沙利铂中位累积剂量为1 200 mg(600~1 500 mg),男性8例,女性6例,中位年龄51岁(43~73岁)。Ⅰ、Ⅱ度过敏反应10例,Ⅲ度过敏反应4例,无Ⅳ度过敏反应的患者。14例患者的皮试结果为:13例阳性。皮试结果与临床的符合率为92.9%。除1例Ⅲ度过敏反应的患者拒绝继续接受奥沙利铂治疗,其余13例均接受了奥沙利铂的再化疗。总体再化疗成功率为100%。 结论:本研究证实了本中心设计的奥沙利铂过敏的干预措施是可行的。奥沙利铂皮试与临床医师判断之间的符合率高。 相似文献
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目的:评估奥沙利铂一线用于治疗晚期结直肠癌后与雷替曲塞联合再引入二线治疗的疗效及安全性。方法:收集2010年5 月至2014年12月广西中医药大学附属瑞康医院收治的48例晚期结直肠癌患者,根据一线应用奥沙利铂的情况分为两组:A 组(一线使用不含奥沙利铂方案)20例;B 组(一线使用含奥沙利铂方案)28例。二线治疗方案:雷替曲塞3 mg/m2,静脉滴注,d1;奥沙利铂100~130 mg/m2,静脉滴注,d1;每21天1 次。结果:48例均可评价疗效,两组有效率分别为30.0%(6/ 20)、32.1%(9/ 28);疾病控制率分别为80.0%(16/ 20)、75.0%(21/ 28);中位无进展生存期分别为6.5 个月、7.0 个月;中位总生存期分别为10个月、13个月;两组有效率、疾病控制率、中位无进展生存期及中位总生存期比较差异均无统计学意义(P = 0.264,0.514,0.713,0.788)。 主要不良反应为骨髓抑制、转氨酶异常和胃肠道反应,以Ⅰ~Ⅱ级为主;两组感觉神经异常Ⅰ~Ⅱ级发生率相近。结论:奥沙利铂再引入联合雷替曲塞二线化疗对曾使用过奥沙利铂一线化疗的患者仍然有效,无耐药性,安全可行,对不能接受伊立替康二线治疗的晚期结直肠癌患者是较好选择。 相似文献
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王康宋彬仇海乐刘燕燕贾军梅 《肿瘤研究与临床》2021,(2):124-128
目的:探讨结直肠癌患者接受含奥沙利铂化疗方案治疗后出现肝功能异常的危险因素、临床特征及预后,为临床诊疗提供相关依据。方法:回顾性分析山西医科大学第一医院2017年10月至2019年5月收治的选用XELOX(奥沙利铂+卡培他滨)方案或mFOLFOX6(奥沙利铂+亚叶酸钙+5-氟尿嘧啶)方案化疗的108例结直肠癌患者临床资... 相似文献
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Suh-Young Lee Hye-Ryun Kang Woo-Jung Song Kyung-Hun Lee Sae-Won Han Sang Heon Cho 《Cancer chemotherapy and pharmacology》2014,73(5):1021-1029
Purpose
This study investigated the characteristics of oxaliplatin-related hypersensitivity reactions (HSR) and evaluated the efficacy of premedication and desensitization administration for controlling HSR in patients with gastrointestinal malignancy.Methods
This retrospective study includes oxaliplatin hypersensitivity cases reported to our in-hospital, adverse drug reaction monitoring system between May 2008 and April 2012. We analyzed administration histories of oxaliplatin and premedication treatments, chemotherapy cycle and severity of the initial HSR, and prophylactic measures and their outcomes in subsequent chemotherapy cycles.Results
One hundred and seventy-three patients showed hypersensitivity to oxaliplatin-based chemotherapy. Oxaliplatin HSR developed after mean chemotherapy cycle 6.3 ± 0.3. Specifically, while HSR occurred at cycle 7.6 ± 0.3 in the case of patients previously unexposed to oxaliplatin-containing chemotherapy, it occurred at cycle 2.6 ± 0.3 in previously exposed patients. Of the 173 patients who exhibited HSR, premedication was administered in 134 patients and 71.6 % of them succeeded in preventing HSR. Desensitization was attempted in 38 patients, including 20 patients in whom premedication administration was unsuccessful, and 89 % of desensitized patients successfully underwent oxaliplatin chemotherapy without HSR. As severity of HSR increased, the success rate by premedication decreased and the percentage of patients that underwent desensitization increased.Conclusions
Attention should be paid to patients with any prior exposure to oxaliplatin, especially during early chemotherapy cycles. Given the high success rate of preventing HSR by desensitization administration and its apparent safety profile, we suggest that desensitization be considered as the first option for the treatment of grades 3 and 4 HSR cases. 相似文献12.
Kidera Y Satoh T Ueda S Okamoto W Okamoto I Fumita S Yonesaka K Hayashi H Makimura C Okamoto K Kiyota H Tsurutani J Miyazaki M Yoshinaga M Fujiwara K Yamazoe Y Moriyama K Tsubaki M Chiba Y Nishida S Nakagawa K 《International journal of clinical oncology / Japan Society of Clinical Oncology》2011,16(3):244-249
Background
Oxaliplatin is a third-generation platinum compound and a key agent for the management of colorectal cancer. Patients treated with oxaliplatin are at risk for hypersensitivity reactions. We designed a modified premedication regimen to prevent oxaliplatin-related hypersensitivity reactions and assessed if this approach is effective.Methods
A retrospective cohort study of patients with advanced colorectal cancer who received modified FOLFOX6 (mFOLFOX6) was performed. Patients received routine premedication with dexamethasone 8?mg and granisetron 3?mg for the first five cycles of mFOLFOX6. From the sixth cycle onward, cohort 1 received the same premedication, and cohort 2 received modified premedication (diphenhydramine 50?mg orally, followed by dexamethasone 20?mg, granisetron 3?mg, and famotidine 20?mg). We compared the incidence of hypersensitivity reactions, duration of treatment, and reasons for treatment withdrawal between the two cohorts.Results
A total of 181 patients were studied (cohort 1, 81; cohort 2, 100). Hypersensitivity reactions developed in 16 patients (20%) in cohort 1 and 7 (7.0%) in cohort 2 (P?=?0.0153). The median number of cycles increased from 9 in cohort 1 to 12 in cohort 2. Apart from progressive disease, neurotoxicity was the reason for discontinuing treatment in 20% of the patients in cohort 1, as compared with 53% in cohort 2.Conclusion
Increased doses of dexamethasone and antihistamine significantly reduced oxaliplatin-related hypersensitivity reactions. This effective approach should be considered for all patients who receive FOLFOX, allowing treatment to be completed as planned. 相似文献13.
A retrospective analysis of the risk factors for allergic reactions induced by the administration of oxaliplatin 下载免费PDF全文
K. Takayoshi MD K. Sagara MD M. Uoi BSC C. Kawanabe BSC M. Matsunaga BSC T. Miyoshi MSC K. Uchino MD N. Misumi BSC T. Nishino BSC 《European journal of cancer care》2015,24(1):111-116
This study retrospectively investigated the clinical features and risk factors of allergic reactions induced by oxaliplatin administration. This study investigated the incidence of allergic reactions and analysed the background and laboratory data in patients with colorectal cancer treated with oxaliplatin‐based chemotherapy at Kyushu Medical Center between April 2012 and September 2012. A total of 62 patients were included in this study. The number of patients in the allergic and non‐allergic groups was 7 and 55 respectively. The incidence of allergic reactions was 11.3%. We compared the patients' characteristics and laboratory data between the two groups and found that the average dose of dexamethasone in the allergic group was significantly lower than that observed in the non‐allergic group (P = 0.0111). Furthermore, the incidence of allergic reactions in the group that received prophylaxis of less than 12 mg of dexamethasone was significantly higher than that observed in the group that received more than 12 mg of dexamethasone (P = 0.0103). In conclusion, a lower dexamethasone dose is a possible risk factor for allergic reactions induced by the administration of oxaliplatin; however, given the retrospective design used in this study, further validation of this finding is warranted. 相似文献
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Hypersensitivity and idiosyncratic reactions to oxaliplatin 总被引:8,自引:0,他引:8
BACKGROUND: Oxaliplatin is a third-generation platinum analog that is used to treat a variety of solid tumors, particularly colorectal carcinoma. Patients may develop hypersensitivity reactions, although this complication occurs infrequently. METHODS: Three patients developed hypersensitivity reactions to oxaliplatin while undergoing treatment on a Phase I trial of oxaliplatin and capecitabine. An Entrez PUBMED search was performed to identify other cases. RESULTS: Two patients experienced the abrupt onset of erythema alone or with pruritis during the 9th and 11th infusions of oxaliplatin, whereas the other patient developed fever and mild dyspnea a few hours after the 9th oxaliplatin infusion. All 3 patients were rechallenged successfully for at least 1 additional oxaliplatin infusion by using oral dexamethasone, 20 mg orally, 6 and 12 hours before the administration of oxaliplatin and by administering intravenously 125 mg of solumedrol, 50 mg of diphenhydramine, and 50 mg of cimetidine 30 minutes before oxaliplatin. The literature review suggests two distinct patterns of reactions: classic hypersensitivity (as experienced by the first two patients) and idiosyncratic reactions (as experienced by the third patient). CONCLUSIONS: Patients who develop mild to moderate hypersensitivity to oxaliplatin may be pretreated with steroids and antagonists of Type 1 and 2 histamine receptors, whereas patients who develop severe reactions are unlikely to tolerate further therapy. 相似文献
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目的 观察含紫杉醇方案化疗时应用小剂量地塞米松预处理的效果及安全性,探索紫杉醇化疗预处理的新方案。方法 151例患者应用紫杉醇联合铂类方案,紫杉醇135~175mg/m2,21天为1周期。依据输注紫杉醇前采用的两种不同地塞米松预处理方案,将151例患者分为标准组(n=75)和小剂量组(n=76),比较两组的不良反应。结果 小剂量组与标准组的急性过敏发生率分别为8.0%、9.2%;外周神经毒性中周围神经炎发生率分别为38.7%、40.8%;肌肉关节痛发生率分别为52.0%、53.9%,两组不良反应差异均无统计学意义。结论 紫杉醇化疗前应用小剂量地塞米松预处理与标准预处理方案合并急性过敏反应的发生率并无差异。 相似文献
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