Analysis of the pattern of hypersensitivity reactions in patients receiving carboplatin retreatment for recurrent ovarian cancer
Analysis of the pattern of hypersensitivity reactions in patients receiving carboplatin retreatment for recurrent ovarian cancer
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DOI：
10.1111/j.1525-1438.2007.01063.x
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发表时间：
2008-07-01
影响因子：
4.8
通讯作者：
Genazzani, A. R.
中科院分区：
文献类型：
--
作者：
Gadducci, A.;Tana, R.;Genazzani, A. R.
本文的目的是评估69例接受卡铂（CBDCA）再治疗复发性卵巢癌患者的超敏反应。15例（21.7%）患者发生超敏反应，其中13例（86.7%）发生在第二个周期的再治疗期间。反应包括8例（53.3%）患者出现皮疹、潮红、瘙痒或腹部绞痛，7例（46.7%）患者出现严重呼吸道或心血管事件。1例患者出现胸痛，无任何其他提示超敏反应的症状，随后心脏骤停，对标准复苏措施无反应。所有其他病例均迅速从症状中恢复。Logistic回归分析显示，过敏史和CBDCA再治疗间隔（一线化疗和CBDCA再治疗的最后一个周期之间的间隔时间）是超敏反应风险的独立预测变量，而患者年龄，一线化疗，一线治疗期间给予的CBDCA总剂量，CBDCA治疗的复发（首次与其他）和复发时的CBDCA方案没有预测价值。CBDCA再治疗间隔超过23.4个月的患者的超敏反应发生率高于间隔较短的患者（36.3% vs 8.3%，P = 0.0132）。9例患者随后接受顺铂治疗，2例（22.2%）仍发生过敏反应。总之，对CBDCA再治疗的超敏反应可能发生在大约五分之一的病例中，CBDCA再治疗间隔超过2年似乎是发生过敏反应的最强预测变量。
The aim of this paper was to assess hypersensitivity reactions in 69 patients who received carboplatin (CBDCA) retreatment for recurrent ovarian cancer. Hypersensitivity reactions developed in 15 (21.7%) patients and occurred during the second cycle of retreatment in 13 (86.7%) of them. Reactions consisted of skin rash, flushing, itching, or abdominal cramping in eight (53.3%) and severe respiratory or cardiovascular events in seven patients (46.7%). One patient had a chest pain, without any other symptoms suggestive of hypersensitivity, followed by cardiac arrest unresponsive to standard resuscitative measures. All the other cases promptly recovered from symptoms. Logistic regression analysis showed that allergy history and CBDCA retreatment interval (interval time between the last cycle of first-line chemotherapy and CBDCA retreatment) were independent predictive variables for the risk of hypersensitivity, whereas patient age, first-line chemotherapy, total CBDCA dose given during first-line treatment, recurrence treated with CBDCA (first versus other), and CBDCA regimen at recurrence had no predictive value. Hypersensitivity reaction rate was higher in patients with CBDCA retreatment interval longer than 23.4 months compared to those with a shorter interval (36.3% versus 8.3%, P = 0.0132). Nine patients were subsequently treated with cisplatin, and two (22.2%) still developed allergic reactions. In conclusion, hypersensitivity reactions to CBDCA retreatment can occur in approximately one fifth of the cases, and a CBDCA retreatment interval longer than 2 years appears to be the strongest predictive variable for the development of allergic reactions.