1例卵巢癌铂耐药复发患者含铂化疗方案药学监护实践  

Pharmaceutical Care of a Patient with Platinum - Resistant Recurrent Ovarian Cancer Treated by Platinum - Based Chemotherapy Regimen

作　　者：陶小芳 陈欢[2] TAO Xiaofang;CHEN Huan(Qianjiang Hospital of Chongqing University,Chongqing,China 409000;Fuling Hospital of Chongqing University,Chongqing,China 408000)

机构地区：[1]重庆大学附属黔江医院,重庆409000 [2]重庆大学附属涪陵医院,重庆408000

出　　处：《中国药业》2024年第18期117-119,共3页China Pharmaceuticals

摘　　要：目的 探讨卵巢癌铂耐药复发患者化学药物治疗(化疗)方案的选择。方法 回顾性分析重庆大学附属涪陵医院收治的1例卵巢癌铂耐药复发患者的治疗过程。临床医师初步拟订化疗方案为注射用紫杉醇(白蛋白结合型)+奥沙利铂。但临床药师会诊时询问病史发现,患者近2次化疗后均出现手、脚麻木,偶有针刺样感,且症状逐渐加重。根据患者用药史、相关指南及临床循证证据,结合其不良反应发生时间,考虑为紫杉醇引起的神经毒性,且奥沙利铂也有较强的神经毒性,与主管医师讨论后建议调整化疗方案为紫杉醇脂质体+卡铂。结果 医师采纳建议。患者化疗期间生命体征平稳,未出现明显的手、脚麻木等神经毒性反应,复查电解质、肝肾功能、血常规等均无异常。结论 临床药师参与卵巢癌铂耐药复发患者含铂化疗方案选择可为患者提供个体化的用药方案,保证患者用药的安全性、有效性,并为类似患者的治疗和管理提供参考。Objective To investigate the selection of chemotherapy regimens for patients with platinum-resistant recurrent ovarian cancer.Methods The treatment process of a patient with platinum-resistant recurrent ovarian cancer admitted to the Fuling Hospital of Chongqing University was retrospectively analyzed.The clinical physicians formulated a chemotherapy regimen consisting of Paclitaxel for Injection(Albumin Bound)+oxaliplatin.However,during the pharmaceutical consultation,the clinical pharmacists inquired about the patient's medical history and found that she had experienced numbness in the hands and feet after the last two rounds of chemotherapy,with occasional needle-like sensations,and the symptoms gradually worsened.Based on the patient's medication history,relevant guidelines,clinical evidence-based evidence,it was considered that the above adverse drug reactions(ADRs)were the neurotoxic reactions induced by paclitaxel according to the occurrence time of ADRs.Due to the strong neurotoxicity of oxaliplatin,the clinical pharmacists suggested adjusting the chemotherapy regimen to paclitaxel liposomes+carboplatin after discussion with physicians-in-charge.Results The physicians adopted the suggestions.The patient's vital signs remained stable during chemotherapy,and there was no obvious neurotoxic reaction such as numbness in the hands or feet;re-examinations of electrolytes,liver and kidney function,blood routine showed no abnormality.Conclusion Clinical pharmacists'participation in the selection of platinum-based chemotherapy regimens for patients with platinum-resistant recurrent ovarian cancer can provide individualized medication regimens,ensure the safety and effectiveness of medication,and provide a reference for the treatment and management of similar patients.

关 键 词：卵巢癌 铂耐药 复发 药学监护 临床药师 

分 类 号：R969.3[医药卫生—药理学] R737.31[医药卫生—药学]