奧沙利鉑治療50例消化道腫瘤的不良反應分析

Characteristics of side effects of 50 gastrointestinal cancer patients treated with oxaliplatin based chemotherapy

目的分析含奧沙利鉑方案治療消化道腫瘤患者的副作用,探索血小板減少以及周圍神經毒性的發生及恢復特點。方法回顧性分析2011年1月~2015年3月期間在鏡湖醫院接受含有奧沙利鉑方案治療的消化道腫瘤患者,分析血液學毒性及周圍神經毒性的發生與恢復。結果50例患者中,血小板減少的Ⅰ~Ⅱ級發生率約為2%~29.7%,Ⅲ級發生率約為2%~6.7%。周圍神經毒性發生率為64%~74%,Ⅱ級以下急性神經毒性佔86.5%,Ⅲ級佔13.5%。慢性神經毒性多發生在化療4週期之後(92.8%),Ⅱ級以下佔90.6%,Ⅲ級佔9.4%。神經毒性在1年之內恢復的比例佔90.4%。神經毒性發生與性別,年齡無關。結論奧沙利鉑治療消化道腫瘤的周圍神經毒性發生率高,多數可在1年內恢復,仍然需要加強隨訪以及醫療宣教,可嘗試中醫,以及針灸治療。

Objective To review and analyze the relationship between clinical characteristics of gastrointestinal(GI)cancer patients and the occurrence of neurotoxicity and thrombocytopenia induced by Oxaliplatin based chemotherapy.Methods Retrospectively review the clinical characteristics of patients who were diagnosed as GI cancers and underwent Oxaliplatin-based chemotherapy in KWH from 2011 to 2015.The incidence of neurotoxicity and thrombocytopenia were analyzed,and we also explored the relations between these side effect and clinical characteristics.Results Totally 50 patients were included.The incidence of grade I and II Thrombocytopenia was 2%-29.7%,and grade III thrombocytopenia was 2-6.7%.The incidence of neurotoxicity was 64-74%.The incidence of grade II and III acute toxicity was 86.5%and 13.5%,respectively.The incidence of grade II and III chronic toxicity was 90.6%and 9.6%respectively.Most chronic neurotoxicity occurred after 4 cycles of chemotherapy.90.4%of neurotoxicity was recovered within 1 year of completion of chemotherapy.Conclusion Although neurotoxicity was common,most will get recovered within 12 months.The role of education,surveillance and traditional Chinese medicine need further study.