BRCA1/2胚系突变状态对卵巢癌初始铂类化疗患者血液毒性影响的回顾性研究

Retrospective analysis of hematologic toxicity among ovarian cancer patients with germline BRCA1/2 mutation status during initial platinum-based chemotherapy

目的:探讨BRCA1/2胚系突变(germline BRCA1/2 mutation,gBRCA1/2m)状态对卵巢癌初始铂类化疗患者血液毒性的影响。方法:通过病例检索系统,统计2019年01月至2021年12月西安交通大学第一附属医院、陕西省肿瘤医院收治的符合入排标准的原发性卵巢癌、腹膜癌和/或输卵管癌患者,对纳入研究患者的疾病分期、病理类型、化疗方案、化疗后血液系统指标等临床信息进行分析。结果:本研究共计纳入87例患者符合入组标准,包括30例BRCA1/2胚系突变携带者(gBRCA1/2m组)和57例BRCA1/2野生型患者(BRCA1/2野生型组),两组平均发病年龄分别为53岁及54岁,两组患者在发病年龄、组织病理、手术、疾病分期、辅助治疗等方面均无统计学差异(P>0.05)。gBRCA1/2m组中90.00%患者在化疗期间出现过血液系统毒副作用,略高于BRCA1/2野生型组的87.72%(P=1.000)。两组在血液毒性类型及骨髓抑制分级(P=0.845)中均未显示出统计学差异。gBRCA1/2m组发生Ⅲ级以上骨髓抑制患者占23.33%,略高于BRCA1/2野生型组的19.30%,但无统计学差异(P=0.659)。两组患者在化疗前后血红蛋白(P=0.577)、血小板(P=0.064)、白细胞(P=0.211)及中性粒细胞计数(P=0.257)的变化方面也均无显著差异。结论:BRCA1/2胚系突变的卵巢癌患者与BRCA1/2野生型患者相比,初始化疗所产生的血液学毒性相似。

Objective:To explore the effect of germline BRCA1/2 mutation(gBRCA1/2 m) status on hematologic toxicity among ovarian cancer patients undergoing initial platinum-based chemotherapy.Methods:The clinical data of patients with primary ovarian,peritoneal and/or fallopian tube cancer,including FIGO stage,pathological type,chemotherapy regimen and blood system index after chemotherapy were reviewed and analyzed from January 2019 to December 2021 in the First Affiliated Hospital of Xi’an Jiaotong University and Shaanxi Provincial Cancer Hospital.Results:A total of 87 patients were involved in this study,including 30 cases with gBRCA1/2 m and 57 cases with BRCA1/2 wild-type.The average onset ages of two groups were 53 and 54 years old,respectively.There was no statistical difference between two groups in age,histopathology,surgery,FIGO stage,and adjuvant treatment(P>0.05).90.00% of patients in the gBRCA1/2 m group experienced hematological toxicities during chemotherapy,which was slightly higher than 87.72% of the BRCA1/2 wild-type group(P=1.000).No difference was found between two groups in the type of hematological toxicity and the grade of bone marrow suppression(P=0.845).Grade Ⅲ or higher bone marrow suppression accounted for 23.33% of patients in gBRCA1/2 m group,which was a bit higher than 19.30% of the BRCA1/2 wild-type group,but there was no statistical difference(P=0.659).Results were analogous in hemoglobin(P=0.577),platelet(P=0.064),white blood cell(P=0.211) and neutrophil count(P=0.257) between the two groups before and after chemotherapy.Conclusion:Ovarian cancer patients with germline BRCA1/2 mutation showed similar hematological toxicities compared with BRCA1/2 wild-type patients during initial chemotherapy.