依维莫司用于晚期恶性肿瘤的不良反应分析  

Retrospective evaluation of adverse drug reactions induced by everolimus in advanced cancer patients

作　　者：王键玮 陶海涛[1,2] 汪进良[1] 董伟伟[1] 李瑞新[1] 胡毅[1] 

机构地区：[1]解放军总医院肿瘤内一科,北京100853 [2]南开大学医学院,天津300100

出　　处：《中国药物应用与监测》2015年第2期101-104,共4页Chinese Journal of Drug Application and Monitoring

基　　金：中国老年学学会老年肿瘤专业委员会基金项目(CGOS-02-2011-1-2-100)

摘　　要：目的：探讨依维莫司临床应用药品不良反应（ADR）的特点和规律，为临床合理用药提供参考。方法：采用回顾性研究方法，收集2013年6月–2014年6月我院服用依维莫司的72例晚期肿瘤患者用药及相关不良反应的信息，按照性别、年龄、病种、ECOG评分、用药情况、不良反应累及系统/器官、临床表现以及转归情况等进行描述性统计学分析。结果：所有患者采用逐步加量法给药，72例患者共发生112例次药品不良反应，以胃肠道系统所占比例最高（40.18%），其次为呼吸系统（23.21%）；其中，1~2级不良反应占总体ADR的82.14%；3~4级不良反应主要为咳嗽（3.57%），口腔炎（2.68%），腹泻（1.79%），62.50%的ADR在用药2周内发生。ADR转归情况方面，80.56%（58/72）的患者给予支持治疗后恢复，继续服药；4例给予药物减量并对症治疗后好转；10例给予完全停药后好转。结论：采用逐步加量法的给药方式，依维莫司临床耐受性良好，ADR多数表现轻微且对症处理均可恢复。应加强对患者的随访，防止严重ADR的发生。Objective： To observe the characteristics and regularities of the adverse drug reactions （ADRs） induced by everolimus, in order to provide reference for clinical application. Methods： A total of 72 patients in our hospital from June 2013 to June 2014 were included. ADRs induced by everolimus were collected and analyzed in respect of sex, age of the patients, entity, ECOG score, condition of drug use, organs or systems involved in ADRs, clinical manifestations, sequelae and other relavant information. Results：The everolimus was applied in a method of increasing the dose gradually. There were 112 ADRs in 72 patients, among which, the percentage of digestive system accounted for the highest （40.18%）, and follwed by respiratory system （23.21%）; the grade 1 –2 ADR accounted for 82.14%; the most common grade 3 –4 adverse reactions were cough （3.57%）, stomatitis （2.68%）, diarrhea （1.79%）; 62.50% of ADRs occurred within 2 weeks. In respect of sequelae, 80.56% （58/72） of the patients recovered with supportive care, 4 cases had to reduce the dose and receive speciifc treatment;10 cases improved after drug withdrawal. Conclusion： By increasing the dose of everolimus gradually, the drug was well tolerated. Since ADRs induced by everolimus were slight, all the ADRs were well managed.It is important to enhance follow-up observations of patients to prevent some serious ADRs.

关 键 词：依维莫司 药品不良反应 合理用药 分析 

分 类 号：R730.5[医药卫生—肿瘤]