化疗致肺癌患者粒细胞减少危险因素的回顾性分析

Risk Factors Analysis for Lung Cancer Patients with Chemotherapy- induced Neutropenia

目的:探讨肺癌常用的两种化疗方案引起患者发生粒细胞减少的危险因素,为临床制定防范措施提供参考。方法:回顾性分析非小细胞肺癌患者应用多西他赛联合顺铂化疗方案和小细胞肺癌患者应用依托泊苷联合顺铂化疗方案的临床资料,通过数据分析找出与粒细胞减少发生率有关的危险因素。结果:粒细胞减少的发生率与患者的年龄(P<0.01)、身体状况评分(KPS评分,P<0.01)和化疗剂量(P<0.01)具有相关性;Logistic回归模型分析显示化疗剂量是肺癌患者发生粒细胞减少的独立危险因素(P=0.009)。结论:对于高龄或KPS评分偏低的患者,可考虑应用细胞毒性较小的化疗药物,或降低化疗药物剂量;合理应用粒细胞刺激因子和地榆升白片对减轻化疗剂量引起的粒细胞减少具有重要意义。

Objective： To discuss the risk factors of neutropenia for lung cancer patients who used common chemo- therapy, and provide reference for clinical use. Methods： A retrospective analysis of patients with non-small cell lung canc- er used docetaxel plus cisplatin and patients with small cell lung cancer used etoposide and cisplatin, then identify the neu- tropenia-related risk factor. Results： The incidence of neutropenia was related to patients＇ age （ P 〈 0.01 ） and physical condition （ KPS score, P 〈 0.01 ） and chemotherapy dose （ P 〈 0.0! ）. Based on a binary logistic regression analysis, chemotherapy dose was a significant independent risk factor for neutropenia （ P = 0.009 ）. Conclusion ： It was better to choose less toxic chemotherapy drugs for those elderly patients and lower KPS score patients, or give lower doses; and it is meaningful to give a rational use of rhG-CSF and burnet root leukopoietic tablets to relieve chemotherapy dose-induced neu- tropenia.