临床药师参与1例妊娠期乳腺癌治疗方案选择实践

Pharmaceutical practice of clinical pharmacists in the selection of therapeutic regimen for a patient with gestational breast cancer

目的对1例妊娠期乳腺癌患者的药物治疗及药学监护过程进行分析讨论,以期为此类特殊患者的临床治疗决策提供参考。方法结合1例妊娠期乳腺癌患者在孕期行化疗的病例,依据循证证据,从化疗指征、化疗方案选择和化疗药物调整、止吐方案等方面进行分析和讨论,并对患者进行药学监护。结果根据循证结果为患者制定了治疗方案,患者顺利完成5个周期化疗,无明显不良反应,末次化疗1个月后剖腹娩出一女婴,母婴状况良好,产后继续抗肿瘤治疗。结论临床药师应发挥自身优势,为特殊患者提供个体化药学服务,在多学科诊疗中体现价值。

Objective To provide some reference for clinical decision making in breast cancer patients during pregnancy by analyzing and discussing the process of drug treatment and pharmacological care of one patient.Methods A case of a pregnant breast cancer patient who underwent chemotherapy during pregnancy was analyzed and discussed based on evi‑dence-based medicine in terms of chemotherapy indications,chemotherapy regimen selection and chemotherapy drug ad‑justment,antiemetic regimen,and pharmacological care of the patient.Results A treatment plan was developed for the pa‑tient based on evidence-based medicine.The patient completed five courses of chemotherapy with no significant adverse re‑actions and delivered a baby girl by caesarean section one month after the last chemotherapy.Both the patient and the baby were in good condition and the patient continued antitumor treatment after delivery.Conclusion Clinical pharmacists should give full play to their own advantages,provide individual pharmaceutical care for special patients,and reflect their value in multidisciplinary diagnosis and treatment.