Oxaliplatin-induced allergic reaction in patients with colorectal cancer in Japan
Oxaliplatin-induced allergic reaction in patients with colorectal cancer in Japan
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DOI：
10.1007/s10147-009-0883-6
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发表时间：
2009-10-01
影响因子：
3.3
通讯作者：
Nakano, Shuji
中科院分区：
文献类型：
--
作者：
Shibata, Yoshihiro;Ariyama, Hiroshi;Nakano, Shuji
奥沙利铂是一种铂类化合物，与5-氟尿嘧啶（5-FU）和甲酰四氢叶酸（LV）联合治疗对结直肠癌（CRC）临床有效，广泛用于转移性疾病和III期CRC的辅助治疗。随着奥沙利铂在日本的使用越来越多，除血液学和神经系统毒性外，还出现了严重的不良事件。为了阐明奥沙利铂过敏反应的临床特征，我们回顾性调查了接受过以奥沙利铂为基础的化疗的CRC患者。125例接受FOLFOX方案治疗的CRC患者，（含奥沙利铂、5-FU和LV），发现21例患者（17%）发生过敏反应。16例患者（13%）发生了1/2级不良事件（根据不良事件通用术语标准（CTC-AE）第3.0版分类），5例（4%）发生了3/4级不良事件。过敏反应出现后，中位数9个周期（范围，2-15个周期）。既往化疗包括5-FU/LV、CPT-11和S-1。所有过敏反应患者经抗过敏药物治疗后均痊愈。在11例患者中重新引入奥沙利铂，使用预防性药物;在8例患者中未观察到对重新引入的过敏反应，3例患者发生1/2级过敏反应。过敏反应与患者的背景特征（如性别、过敏史和其他不良事件）之间没有相关性，奥沙利铂过敏反应仍然是患者能否安全继续有效化疗的重要问题;需要进一步分析以建立预测和预防此类反应的方法。
Oxaliplatin is a platinum compound that is clinically effective for colorectal cancer (CRC), in combination with 5-fluorouracil (5-FU) and leucovorin (LV), and it is widely used for metastatic disease and for the adjuvant treatment of stage III CRC. With the increasing use of oxaliplatin in Japan, serious adverse events have been experienced other than hematologic and neurologic toxicities.In order to clarify the clinical features of allergic reactions to oxaliplatin, we retrospectively investigated CRC patients who had received oxaliplatin-based chemotherapies.One hundred and twenty-five CRC patients who had been treated with FOLFOX regimens (containing oxaliplatin, 5-FU, and LV) were examined, and 21 patients (17%) were found to have developed allergic reactions. Sixteen patients (13%) had grade 1/2 adverse events, classified according to the common terminology criteria for adverse events (CTC-AE) version 3.0 and 5 (4%) had grade 3/4 adverse events. The allergic reaction appeared after a median number of nine cycles (range, 2-15 cycles). Previous chemotherapy included 5-FU/LV, CPT-11, and S-1. All of the patients with allergic reactions recovered completely when treated with antiallergy drugs. Oxaliplatin was reintroduced in 11 patients, with the use of prophylactic agents; allergic reaction to the reintroduction was not observed in 8 patients and grade 1/2 allergic reactions developed in 3 patients. No correlation was identified between allergic reaction and patients' background characteristics such as sex, history of allergy, and profile of other adverse events.Allergic reactions to oxaliplatin remain an important issue for patients being able to safely continue effective chemotherapies; further analysis will be needed to establish methods for the prediction and prophylaxis of such reactions.