多西他赛联合吉西他滨与帕唑帕尼治疗晚期恶性子宫苗勒氏混合瘤的安全性分析

A safety analysis in patients treated with gemcitabine/docetaxel/pazopanib combination for advanced malignant mixed mullerian tumor of the uterus

目的观察帕唑帕尼、多西他赛与吉西他滨用于晚期子宫苗勒氏混合瘤患者的安全性和耐受性。方法回顾性分析32例晚期子宫苗勒氏混合瘤患者采用多西他赛联合吉西他滨化疗与帕唑帕尼治疗的临床资料,分析其不良反应,并进行随访观察。结果最常见的不良反应为白细胞及中性粒细胞减少、血红蛋白降低（各15例,各占比46.9%）,其次为乏力（14例,占比43.6%）,最常见的Ⅲ~Ⅳ度血液学毒性为白细胞及中性粒细胞降低（6例,占比18.6%）。≥55岁患者化疗后白细胞及中性粒细胞减少和血小板降低的发生率高于〈55岁患者,其中白细胞及中性粒细胞降低发生率分别为75.0%和30.0%（P=0.035）,血小板降低发生率分别为75.0%和15.0%（P=0.002）。≥55岁和〈55岁患者血红蛋白降低、乏力、过敏反应、肝功能受损、高血压的发生率差异均无统计学意义（P〉0.05）,总体不良反应均轻微。结论多西他赛联合吉西他滨化疗与帕唑帕尼治疗晚期子宫苗勒氏混合瘤的不良反应是可以耐受的,尤其〈55岁的老年患者耐受性好。

Objective To analyze the safety and compliance of this combination regimen（gemcitabine/docetaxel/pazopanib）in patients with advanced malignant mixed mullerian tumor of the uterus. Methods Clinical data of 32 patients with Malignant mixed Mullerian tumor of the uterus treated with Gemcitabine/Docetaxel/Pazopanib combination chemotherapy were retrospectively reviewed.The types and incidence rate of adverse events related to chemotherapy and the results of follow up of the patients were analyzed. Results The most common adverse events were leukopenia and neutropenia （n=15, 46.9%）, anemia （n=lS, 46.9%）, and fatigue （n=14, 43.6%）.The most frequent grade 3~4 toxicities were leukopenia and neutropenia （n--6, 18.6%）. The complications of leukopenia, neutropenia and thrombocytopenia in patients 1〉 55 years old were higher than those of 〈55 years old; the complication rate of leukopenia and neutropenia in patients were 75.0% （ ≥ 55 years old） and 30.0% （〈55 years old）, respectively （P=0.035） ; the complication rate of thrombocytopenia were 75.0% （≥55 years old） and 15.0% （〈55 years old）, respectively （P=0.002）. The rates of adverse events （anemia, fatigue, allergies, liver dysfunction, hypertension） in patients aged 〉155-years were similar to those in younger patients. Conclusion The combination of gemcitabine/docetaxel/pazopanib was well tolerated by patients with malignant mixed mullerian tumor of the uterus especially of 〈55 years old.