摘要
目的探讨多柔比星脂质体治疗乳腺癌的安全性。方法回顾性分析解放军第九六〇医院甲状腺乳腺外科2018年10月至2021年9月使用含多柔比星脂质体药物方案的乳腺癌患者的临床资料,分析患者选择使用多柔比星脂质体的原因,评价心脏毒性以及其他不良反应。结果共收集215例病例资料。患者选择使用多柔比星脂质体具有主、客观原因。客观原因包括:既往心脏疾病病史(5例,2.3%)、高龄(≥65岁)(11例,5.1%)、心血管病史或心脏疾病遗传因素(15例,7.0%)及合并左乳放射治疗(75例,34.9%)。主观原因包括:对脱发、骨髓抑制、消化道等不良反应特别关注(57例,26.5%),以及年轻患者重视日后生活质量、关注药物的远期心脏毒性(52例,24.2%)。共5例(2.3%,5/215)患者发生心功能损害。其他不良反应为白细胞减少(34.9%,75/215)、脱发59例(27.4%,59/215)、恶心及呕吐41例(19.1%,41/215)、手足麻木15例(7.0%,15/215)、血小板减少41例(19.1%,41/215)。特有的不良反应中手足综合征共11例(5.1%,11/215),并且,在使用本药物的前30例患者中有15例第1次化疗期间发生急性输液反应,其中1例第2次化疗时仍然发生,临床表现为潮红、呼吸困难,给予停药、扩充血容量后缓解,之后降低输液速度完成了治疗。结论多柔比星脂质体在临床上应用有降低心脏毒性的客观原因和患者意愿选择的主观原因。其在临床上应用是安全的,但应注意不良反应发生,特别应注意其特有的手足综合征和输液反应。
Objective To investigate the safety of liposomal doxorubicin in the treatment of breast cancer.Methods We retrospectively analyzed the clinical data of breast cancer patients who were treated with liposomal doxorubicin in the Department of Thyroid and Breast Surgery,the 960th Hospital of PLA from October 2018 to September 2021.The reasons for choosing liposomal doxorubicin were analyzed.The cardiac toxicity and other adverse reactions were evaluated.Results A total of 215 cases were collected.Objective reasons for choosing liposomal doxorubicin were as follow:previous history of heart disease in 5 cases(2.3%),advanced age(≥65 years old)in 11 cases(5.1%),history of heart disease or genetic factors of heart disease in 15 cases(7.0%)and left breast radiotherapy in 75 cases(34.9%).Subjective reasons were as follow:special concern about chemotherapy toxicity in 57 cases(26.5%)and concern about long-term quality of life and drug-induced cardiotoxicity in 52 cases(24.2%).Five patients had impaired cardiac function.Other adverse reactions were as follow:leukopenia(34.9%,75/215),hair loss(27.4%,59/215),nausea and vomiting(19.1%,41/215),numbness of hands and feet(7.0%,15/215)and thrombocytopenia(19.1%,41/215).Among the unique adverse reactions,hand-foot syndrome occurred in 11 cases(5.1%,11/215).Among the first 30 patients taking this drug,15 patients had acute infusion reaction during the first chemotherapy cycle,including one patient who still had acute infusion reaction during the second cycle,with clinical symptoms of flushing and dyspnea relieved after drug withdrawal and blood volume expansion,and completed the treatment after reducing the infusion rate.Conclusions Due to objective and subjective factors,liposomal doxorubicin is applied in clinic,which is safe.However,attention should be paid to its adverse reactions,especially hand-foot syndrome and infusion reaction.
作者
于芳
刘旭
王刚
贺青卿
Yu Fang;Liu Xu;Wang Gang;He Qingqing(Department of Thyroid and Breast Surgery,the 960th Hospital of PLA Joint Logistic Support Force,Jinan 250031,China;Graduate School of Jinzhou Medical University,Jinzhou 121000,China)
出处
《中华乳腺病杂志(电子版)》
CAS
CSCD
2022年第4期219-224,共6页
Chinese Journal of Breast Disease(Electronic Edition)
关键词
乳腺肿瘤
化学疗法
长期不良反应
多柔比星
Breast neoplasms
Chemotherapy
Long term adverse effects
Doxorubicin
