妇科恶性肿瘤患者TC方案化疗后发生重度骨髓抑制的影响因素

Related factors of severe bone marrow suppression of patients with gynecologic malignant tumor after chemotherapy with TC program

目的：研究紫杉醇＋奈达铂（TC）方案化疗后3～4 d出现重度骨髓抑制的影响因素。方法：接受TC化疗的妇科恶性肿瘤患者118例,化疗后出现0、Ⅰ度骨髓抑制者58例（轻度组）,Ⅱ、Ⅲ、Ⅳ度骨髓抑制者60例（重度组）,采用单因素分析探讨年龄、体重指数、体表面积、有无内科并发症、肿瘤分期、化疗疗程、肿瘤类型等因素与重度骨髓抑制发生的关系,采用logistic回归分析探讨化疗后出现重度骨髓抑制的影响因素。结果：单因素分析结果表明年龄、肿瘤类型、肿瘤分期、化疗疗程与重度骨髓抑制有关（P＜0.05）。Logistic回归分析表明宫颈癌、肿瘤分期、化疗疗程是重度骨髓抑制的影响因素（OR=0.046、2.357、3.121,P＜0.05）。结论：肿瘤分期晚、化疗次数多是妇科恶性肿瘤患者TC方案化疗后发生重度骨髓抑制的高风险因素; 宫颈癌患者发生重度骨髓抑制的风险低于卵巢癌患者。

Aim： To research the related factors of severe bone marrow suppression occurred within 3-4 days after the chemotherapy with paclitaxel and nedaplatin（TC program）in patients with gynecologic malignant tumor.Methods： A total of 118 patients with gynecologic malignant tumor were treated with TC chemotherapy,among whom, 58 developed grade 0 to Ⅰ bone marrow suppression（mild group）,and 60 developed grade Ⅱ or Ⅲ or Ⅳ bone marrow suppression（severe group）. The relationship between related factors such as age, body mass index, body surface area, internal medicine amalgamative disease, tumor staging, chemotherapy course, tumor type and severe bone marrow suppression after chemotherapy was analyzed by single factor analysis. The influencing factors of severe bone marrow suppression were analyzed by logistic regression analysis.Results： Univariate analysis showed that age, tumor type, tumor stage, chemotherapy course were related to severe bone marrow depression（P〈0.05）. Logistic regression analysis showed that cervical cancer,tumor stage, and chemotherapy course were related to severe bone marrow depression（OR=0.046,2.357,3.121,P〈0.05）.Conclusion： Late stage of tumor, number of chemotherapy course are the risk factors for the occurrence of severe bone marrow suppression; the patients with cervical cancer have lower risk of developing severe bone marrow suppression than those with ovarian cancer.