肿瘤多发性骨转移89SrCl2治疗后的血液毒性及不良反应研究

Hematological toxicity of 89SrC12 in patients with multiple bone metastases

目的观察肿瘤多发性骨转移89SrCl2治疗后的血液毒性及不良反应,分析相关危险因素。方法前瞻性纳入2015年12月至2017年6月间89例肿瘤多发性骨转移89SrCl2治疗的患者,其中男63例、女26例,年龄(62.3±5.2)岁;分析其治疗前和治疗2和4周后的血液学资料,参照通用不良事件术语标准(CTCAE)v4.03进行评价,分析发生血液毒性及不良反应的影响因素。采用logistic回归分析数据。结果89SrCl2治疗2和4周后出现I~Ⅱ级贫血、WBC和PLT减少发生率分别为15.7%(14/89), 18.0%(16/89),11.2%(10/89)和 18.0%(16/89),24.7%(22/89)和 18.0%(16/89);出现Ⅲ-IV 级贫血、WBC 和 PLT 减少发生率分别为 2.2%(2/89)、0、0 和 2.2%(2/89),2.2%(2/89)、3.4%(3/89)0 Logistic回归显示骨转移灶数目与治疗前Hb水平是89SrCl2治疗后出现血液毒性及不良反应的独立影响因素,其比值比(OR)分别为2.200(95% Cl;1.269~3.841)和0.961 (95% Cl:0.932-0. 991)。结论89SrCl2治疗后严重血液毒性及不良反应少见;骨转移灶数目与治疗前Hb水平是治疗后出现血液毒性及不良反应的独立影响因素。

Objective To observe the hematological toxicity of 89SrCl2 in patients with multiple bone metastases of malignant tumors, and analyze the related-risk factors. Methods A total of 89 patients (63 males, 26 females;age:(62.3±5.2) years) with multiple bone metastases and treated with 89SrCl2 were enrolled. Hematological data at 2 and 4 weeks after treatment with 89SrCl2 were analyzed. Common Terminology Criteria for Adverse Events (CTCAE) v4.03 was used to evaluate the hematological toxicity, and the influencing risk factors were analyzed. Logistic regression analysis was used to analyze the data. Results The incidences of grade Ⅰ~Ⅱ anemia, leukopenia and thrombocytopenia at 2 and 4 weeks after treatment were 15. 7%(14/89), 18.0%(16/89), 11.2%(10/89) and 18.0%(16/89), 24.7%(22/89), 18.0%(16/89), respectively. The incidences of grade Ⅲ-IV anemia, leukopenia and thrombocytopenia were 2.2%(2/89), 0, 0 and 2.2%(2/89), 2.2%(2/89), 3.4%%(3/89), respectively. Logistics multivariate analysis showed that the number of bone metastases and the Hb level before treatment were independent effect factors for hematological toxicity of 89SrCl2, with odds ratio (OR) values of 2.200(95% Cl: 1.269-3.841) and 0. 961(95% Cl:0.932-0.991), respectively. Conclusions Serious hematological toxicity after 89SrCl2 treatment is rare. The number of bone metastases and the Hb level before treatment are independent effect factors for hematological toxicity.