原发性肝癌肝动脉灌注奥沙利铂致过敏反应的临床分析  

Clinical analysis of allergic reactions caused by oxaliplatin via transcatheter arterial chemoembolization in patients with primary hepatocellular carcinoma

作　　者：朱方勇 陈颢[2] 花永强[2] 陈其文[2] 沈晔华[2] 

机构地区：[1]福建省福鼎市医院肿瘤内科,福建福鼎355200 [2]复旦大学附属肿瘤医院中西医结合科,上海200032

出　　处：《肿瘤》2014年第6期547-549,563,共4页Tumor

摘　　要：目的：探讨原发性肝癌肝动脉灌注奥沙利铂致过敏反应的发生率、临床表现及其预防和处理对策。方法：研究对象为2011年10月--2013年10月在复旦大学附属肿瘤医院接受奥沙利铂肝动脉灌注化疗的677例原发性肝癌患者，分析奥沙利铂过敏反应的发生率及其临床特征。结果：677例患者中，18例（2．7％）发生奥沙利铂过敏，其中17例为轻～中度过敏反应，1例表现为重度过敏反应，给予常规吸氧、抗组织胺药物和类固醇激素治疗后，均可缓解。接受〉3次奥沙利铂肝动脉灌注化疗的263例患者中，发生过敏的患者有16例（6。1％），过敏发生率显著高于接受1～3次的414例患者（0．5％），差异有统计学意义（P〈0．001）。结论：肝动脉灌注奥沙利铂治疗原发性肝癌较为安全，但肝动脉灌注化疗次数〉3次者易引起过敏反应，应引起重视。Objective： To investigate the clinical manifestations and incidence rate of allergic reactions caused by oxaliplatin via transcatheter arterial chemoembolization （TACE） and the related prevention and treatment measures for patients with primary hepatocellular carcinoma. Methods： The medical records of 677 patients with primary hepatocellular carcinoma treated with oxaliplatin via TACE between October 2011 and October 2013 were retrospectively reviewed. The clinical manifestations and incidence rate of allergic reactions caused by oxaliplatin were evaluated. Results： Eighteen patients （2.7%, 18/677） developed allergic reactions caused by oxaliplatin, including 17 patients with mild to moderate allergic reactions and one patient with severe allergic reactions. Conventional oxygen therapy, antihistamines and steroids were used and all allergic symptoms were effectively alleviated. The incidence rate of allergic reactions of 263 patients who received TACE more than 3 cycles was significantly higher than that of 414 patients received 1-3 cycles of TACE （6.1% vs 0.5%, P 〈 0.001 ）. Conclusion： It is safe to use oxaliplatin via TACE for patients with primary hepatocellular carcinoma. The patients who receive more than three cycles of TACE are more likely to develop allergic reactions and more attention should be paied on this problem.

关 键 词：肝细胞癌 动脉导管化疗栓塞 奥沙利铂 过敏反应 

分 类 号：R735.7[医药卫生—肿瘤]