紫杉类联合表柔比星治疗乳腺癌引起严重中性粒细胞减少的影响因素分析

Analysis of incidence and risk factors for severe neutropenia in breast cancer patients receiving taxanes and epirubicin combination chemotherapy

目的:分析紫杉类联合表柔比星方案(TE)治疗乳腺癌引起的严重中性粒细胞减少情况及其相关影响因素。方法:回顾性分析2014-2015年于某院接受TE方案新辅助化疗及晚期化疗的患者,收集患者生理、病理、用药等因素及化疗后中性粒细胞减少的情况,采用Logistic回归分析评估各因素与发生严重中性粒细胞减少的相关性。结果:共分析了126例患者,有50例(39.7%)化疗后出现Ⅳ度中性粒细胞减少(严重中性粒细胞减少),其中45例(35.7%)发生于首次化疗后。考察的各因素中,紫杉类用药为紫杉醇脂质体(OR=5.84,P=0.003)和表柔比星剂量强度(OR=1.11,P=0.001)是TE方案首次化疗后发生严重中性粒细胞减少的独立危险因素。结论:我国乳腺癌患者接受TE方案化疗后出现严重中性粒细胞减少的风险较高,使用紫杉醇脂质体和较高的表柔比星剂量强度可能使风险增加。

OBJECTIVE To evaluate the incidence and risk factors for severe neutropenia in breast cancer patients receiving taxanes and epirubicin（TE）combination chemotherapy.METHODS Retrospective analysis was performed for breast cancer patients receiving TE combination regimen for neoadjuvant or systemic chemotherapy from2014 to 2015 in Tianjin Medical University Cancer Institute and Hospital.Patients＇ data of physiology,pathology,medications and the results of neutropenia were collected,and risk factors of severe neutropenia were analyzed by logistic regression.RESULTS Totally 126 patients were analyzed in this study,50 patients（39.7%）developed severe neutropenia during chemotherapy,and 45（35.7%）patients developed after the first cycle treatment.Among these factors,paclitaxel liposome as the taxane（OR=5.84,P=0.003）and higher dose intensity of epirubicin（OR=1.11,P=0.001）were found to be associated with a higher risk of severe neutropenia.CONCLUSION Chinese breast cancer patients are at relatively high risks of severe neutropenia when receiving TE regimen chemotherapy,paclitaxel liposome and higher dose intensity of epirubicin may increase the risk.