肠癌患者化疗中严重不良反应的防治对策

Prevention and treatment of severe transfusion reactions in patients with colorectal cancer

目的:从临床药师的角度探讨肠癌患者化疗过程中出现严重不良反应的防治对策。方法:回顾典型病例及文献学习,分析肠癌患者的严重不良反应,讨论防治对策。结果:患者使用伊立替康前需使用阿托品进行预处理;奥沙利铂过敏反应通常发生在多个用药周期之后,同时联合蛋白类靶向药物(如贝伐珠单抗)更易发生过敏反应;使用西妥昔单抗容易导致严重皮症的发生,且发病率和严重程度通常与西妥昔单抗剂量相关。结论:临床上,肠癌患者化疗时应该注意高危患者的筛查,出现严重输液反应时应注意临床症状的鉴别,及时准确选择合理的治疗药物,规范化疗前预处理,降低抗癌治疗中的不良反应。

Objective:To discuss the prevention and treatment of serious adverse reactions in the chemotherapy of patients with colon cancer from the perspective of clinical pharmacists.Methods:The serious adverse reactions of colon cancer patients were analyzed by reviewing typical cases and literature and the prevention and treatment measures were discussed.Results:Patients needed to be pretreated with atropine before using irinotecan.Allergy caused by oxaliplatin usually occurred after several cycles of medication and was even more likely to occur when it was combined with protein targeted drugs(such as bevacizumab).Severe skin lesions were caused when cetuximab was used and the incidence and severity were usually associated with its dose.Conclusion:Great attention should be paid in clinic to the screening of high-risk patients during chemotherapy to patients with colorectal cancer and also to the identification of clinical symptoms when a serious infusion reaction occurred,and the reasonable treatment drugs should be timely and accurately selected and the pretreatment should be also standardized before chemotherapy so as to reduce the adverse reactions in anti-cancer treatment.