摘要
目的:探讨卵巢上皮性癌患者应用奥拉帕利治疗的不良反应和依从性,分析对3~4级血液系统不良反应的影响因素。方法:回顾性分析2018年8月至2021年4月期间在北京大学第三医院妇科接受奥拉帕利治疗的卵巢上皮性癌患者的病历资料及随访结果。通过单因素和多因素分析方法,分析年龄、病理分期、化疗疗程、是否联用血管上皮生长因子抑制剂、既往化疗骨髓抑制病史等对3~4级血液系统不良反应发生的影响。结果:研究共收集了73例卵巢上皮性癌患者的临床资料。自患者应用奥拉帕利开始随访,中位随访时间7(1~32)月。45例(61.64%)患者因不良反应出现治疗中断或剂量减少,13例(17.81%)患者因不良反应停止治疗。其中3~4级血液系统不良反应所致治疗中断或剂量减少、停止治疗分别占35.56%、53.85%。经单因素分析发现,病理分期、是否联用血管上皮生长因子抑制剂、既往化疗骨髓抑制病史与3~4级血液系统不良反应有关(P<0.10)。多因素分析结果显示,联合血管上皮生长因子抑制剂治疗是3~4级血液系统不良反应的独立危险因素(OR 7.828,P=0.007)。结论:3~4级的血液系统不良反应是奥拉帕利治疗卵巢上皮性癌患者发生治疗中断、剂量减少及停止治疗的最主要原因。奥拉帕利联合应用血管上皮生长因子抑制剂治疗时发生3~4级血液系统不良反应的风险显著增高。
Objective:To investigate the adverse events and compliance in patients with ovarian epithelial carcinoma treated with olaparib and to analyze the factors influencing the grade 3-4 hematologic adverse events.Methods:The medical records and follow-up results of patients with ovarian epithelial carcinoma treated with olaparib at the Department of Gynecology,Peking University Third Hospital between August 2018 and April 2021 were retrospectively analyzed.Univariate and multivariate analyses were used to measure the effect of risk factors(such as age,pathological stage,chemotherapy course,a combination of vascular epithelial growth factor inhibitors,history of previous chemotherapy-induced myelosuppression,etc.)on the occurrence of grade 3-4 hematologic adverse events.Results:The clinical data of 73 patients with ovarian epithelial carcinoma was collected in the study.Follow-up began after the patient were treated with olaparib and the median follow-up time was 7(1-32)months.45 patients(61.64%)experienced treatment interruption or dose reduction due to adverse events,while 13 patients(17.81%)discontinued treatment.Of these,grade 3-4 hematologic adverse events led to 35.56%of dose reduction or interruption,and 53.85%of treatment discontinuation.Univariate analysis demonstrated that pathological stage,a combination of vascular epithelial growth factor inhibitors,and history of previous chemotherapy-induced myelosuppression were significantly associated with grade 3-4 hematologic adverse events(P<0.10).Multivariate analysis showed that combination therapy with vascular epithelial growth factor inhibitors was an independent risk factor for grade 3-4 hematologic adverse events(OR 7.828,P=0.007).Conclusions:Grade 3-4 hematologic adverse events were the major cause of treatment interruption,dose reduction,and discontinuation in patients with ovarian epithelial carcinoma during olaparib treatment.The risk of grade 3-4 hematologic adverse events was significantly elevated with olaparib in combination with vascular epithelial g
作者
黄宗耀
高妍
李圆
吴郁
梁华茂
郭红燕
HUANG ZongYao;GAO Yan;LI Yuan(Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100191,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2022年第10期759-763,共5页
Journal of Practical Obstetrics and Gynecology
基金
北京市自然科学基金(编号:J200015)。
