潮汕地区铂类抗肿瘤药物不良反应报告分析

Analysis on adverse reactions induced by platinum anti-tumor drugs in Chaoshan area

目的探讨潮汕地区铂类药物不良反应的发生规律及特点,为临床安全用药及管理提供参考。方法统计分析2009—2020年汕头大学医学院附属肿瘤医院上报的铂类抗肿瘤药物(顺铂、卡铂、奈达铂及奥沙利铂)相关不良反应的例数、分布、症状及原疾病数据。结果上报铂类药物相关不良反应399例(占抗肿瘤药物比40.96%),其中严重的不良反应65例;铂类药物相关不良反应的患者以50~70岁居多(270例,占比67.67%);所有不良反应以过敏、皮疹及骨髓抑制等免疫系统症状最多见(182例,占比45.61%);以奥沙利铂引起的不良反应例数最多(159例,占比39.85%);新的不良反应共59例,其中23例为说明书已记载反应;发生不良反应患者原患的疾病主要为结直肠癌。结论铂类抗肿瘤药物引起的不良反应占比最高(尤其是奥沙利铂),相关症状主要累及免疫系统。用药时应对患者进行严密看护,加强临床医师与药师的及时沟通,并采用防治手段减少不良反应的发生。

Objective To investigate the adverse reactions induced by the platinum anti-tumor drugs in cancer hospital of Chaoshan area and provide reference on the rational clinical use and management.Methods A retrospective analysis on the platinum drug adverse reaction cases and distribution,symptom and disease was implemented during from 2009 to 2020 of the Cancer Hospital of Shantou University Medical College,including Cis-platinum,Carboplatin,Nedaplatin and Oxaliplatin.Results A total of 399 suspected cases on the platinum drugs were reported,taking a proportion of 40.96%.while with 65 cases of severe adverse reaction in all events.Patients with the age from 50~70 years old took the most cases as 270,with a proportion of 67.67%.The most common symptoms were allergies,rashes and bone marrow suppression in all adverse reactions,182 cases with a proportion of 45.61%.Oxaliplatin caused the most cases as 159,with a proportion of 39.85%.A total of 59 cases were reported as the new adverse reactions but 23 of them were recorded in the drug instruction.Colorectal cancer were the mainly common diseases of the patients with the adverse reactions.Conclusion Adverse reaction cases induced by the platinum drugs accounted for the highest proportion,especially for the Oxaliplatin,and the related symptoms mainly reflected in immune system.Closely monitoring,seasonable communication between doctors and pharmacists and preventive measures should be used to reduce adverse reactions.