摘要
目的探讨卡铂联合紫杉醇（Tc）方案中不同药物剂量对卵巢癌患者骨髓抑制的影响。方法回顾性分析2002年1月至2007年12月间在北京妇产医院妇瘤科采用Tc方案化疗的卵巢癌患者62例（共196个疗程）的骨髓抑制情况。卡铂剂量的确定：以血浆浓度一时间曲线下面积（AUC）4～6为卡铂低剂量（147个疗程），AUC〉6—7为卡铂高剂量（49个疗程）；紫杉醇剂量的确定：以135-〈150mg／m^2为紫杉醇低剂量（37个疗程），150～175mg／m^2为紫杉醇高剂量（159个疗程）。根据每个疗程后血常规检查结果确定骨髓抑制程度，采用x^2检验（单因素分析）及logistic回归法（多因素分析）分析影响骨髓抑制的相关因素，包括年龄、身高、体质量、体表面积、病理分化程度、病理类型、手术病理分期、血清肌酐浓度、内生肌酐清除率、出现骨髓抑制的疗程序列数（疗程数）、卡铂剂量、紫杉醇剂量；并采用X^2检验分析Tc方案中不同卡铂和紫杉醇剂量对骨髓抑制的影响。结果（1）骨髓抑制情况：轻度骨髓抑制（0～11度）共159个疗程，占81．1％；重度骨髓抑制（Ⅲ～Ⅳ度）共37个疗程，占18．9％。（2）影响骨髓抑制的相关因素：单因素分析显示，疗程数、年龄、手术病理分期、血清肌酐浓度、内生肌酐清除率、卡铂剂量是影响骨髓抑制程度的因素（P值分别为0．000、0．000、0．018、0．033、0．001、0．000）；而身高、体质量、体表面积、病理分化程度、病理类型和紫杉醇剂量与骨髓抑制程度无关（P均〉0．05）。多因素分析显示，疗程数、年龄、卡铂剂量是影响骨髓抑制程度的独立危险因素（P值分别为0．030、0．043、0．009）。（3）紫杉醇低剂量的疗程中，卡铂高剂量者重度骨髓抑制的发生率（4／14）高于卡铂低剂量者（0），差异有统计学意义（P=0．015）；紫杉醇高剂量�
Objective To analyze the relative factors of bone marrow suppression after chemotherapy with different-dose carboplatin and paclitaxel （TC） on the patients with ovarian cancer. Methods Sixty-two patients with ovarian cancer admitted in Beijing Obstetrics and Gynecology Hospital from January 2002 to December 2007, using TC regimen ,a total of 196 cycles of chemotherapy,were divided into two groups by the doses of earboplatin [ area under concentration-time curve （AUC） 4 -6 for low-dose, AUC 〉 6 -7 for hight-dose, the carboplatin dose calculated with AUC ] or by the doses of paelitaxel （ 135 - 〈 150 mg/m2 low-dose,150- 175 mg/m2 hight-dose）. After each TC cycle, the routine blood was test to determine the graduation of the marrow suppression, and then the correlation factors were analyzed with logistic regression. Results （ 1 ） The occurrence rate of bone marrow suppression： there were 159 cycles （81.1%） grade 0 - II bone marrow suppression, while 37 cycles （18.9%） of gradeⅢ - IV. （2） Factors related to bone marrow suppression：the results shown that there were not related to bone marrow suppression,which incluced cellular differentiation, tumor type, height, weight and paclitaxel dose （P 〉 0. 05）. While, the different cycle, age, the later stages of tumor, serum creatinine concentration, endogenous creatinine clearance rate, AUC values were the relative factors of bone marrow suppression（P =0. 000,0. 000,0. 018, 0. 033, 0. 001,0. 000）. Seven variables were conducted into the logistic regression and the results shown that the different cycles, the age, AUC grades were independent risk factors （ P = 0. 030,0. 043,0. 009 ）. （3） When low-dose of paclitaxel was given, the occurrence of bone marrow suppression was related to the carboplatin dose AUC. The higher AUC values for carbopaltin were chosen, the higher of severe bone marrow suppression would happen. （4/14 vs 0, P = 0. 015 ）. When the dose of high grade of paclitaxel was given, the occurrence of bone ma
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2011年第3期188-192,共5页
Chinese Journal of Obstetrics and Gynecology
关键词
卡铂
紫杉酚
骨髓
抗肿瘤联合化疗方案
曲线下面积
Carboplatin
Paclitaxel
Bone marrow
Antineoplastic combined chemotherapyprotocols
Area under curve
