摘要
目的 分析鼻咽癌患者应用紫杉醇联合铂类同步放射治疗、化学药物治疗(简称放化疗)并发中性粒细胞减少症影响因素,并为预防性合理应用重组人粒细胞刺激因子(rhG-CSF)提供参考。方法 选取医院2019年1月至2021年12月收治的鼻咽癌患者120例,统计患者应用紫杉醇联合铂类同步放化疗后并发中性粒细胞减少症的发生情况,采用单因素及多因素Logistic回归分析找出中性粒细胞减少相关影响因素;统计rhG-CSF预防性使用的合理情况。结果 120例患者应用紫杉醇联合铂类同步放化疗致中性粒细胞减少发生率为31.67%;单因素分析结果提示,年龄、肥胖情况、高血压史、糖尿病史、营养支持情况、给药方案、治疗周期均为显著相关影响因素(P <0.05);多因素Logistic回归分析结果提示,年龄≥65岁[OR=10.135,95%CI(2.428,42.302),P <0.001]、紫杉醇+顺铂治疗方案[OR=4.129,95%CI(2.019,8.444),P <0.001]、治疗周期> 4周期[OR=9.689,95%CI(1.799,52.177),P=0.016]均为独立危险因素,肠内营养支持[OR=0.143,95%CI(0.035,0.579),P=0.009]为独立保护因素。rhG-CSF预防性应用不合理率为31.58%(6/19)。结论 高龄(≥65岁)、基于顺铂的治疗方案、长治疗周期(> 4周期)均是影响鼻咽癌应用紫杉醇联合铂类同步放化疗并发中性粒细胞减少症的独立危险因素,给予肠内营养支持则为独立保护因素;该院临床预防性应用rhG-CSF的合理性有待提升。
ObjectiveTo analyze the influencing factors of neutropenia in nasopharyngeal carcinoma patients treated by paclitaxel combined with platinum-based concurrent chemoradiotherapy,and to provide a reference for the rational prophylactic use of recombinant human granulocyte stimulating factor(rhG-CSF).MethodsA total of 120 patients with nasopharyngeal carcinoma admitted to the hospital from January 2019 to December 2021 were selected. The incidence of neutropenia in patients treated by paclitaxel combined with platinum-based concurrent chemoradiotherapy was statistically analyzed. Univariate and multivariate Logistic regression analysis was used to identify the relevant factors affecting neutropenia. The rationality of prophylactic use of rhG-CSF was analyzed.ResultsThe incidence of neutropenia in 120 patients treated by paclitaxel combined with platinum-based concurrent chemoradiotherapy was 31. 67%. The results of the univariate analysis showed that age,obesity,history of hypertension,history of diabetes,nutritional support,administration scheme and treatment cycle were all significantly relevant influencing factors(P < 0. 05). The results of the multivariate Logistic regression analysis showed that age ≥ 65 years old [OR = 10. 135,95% CI(2. 428,42. 302),P < 0. 001],paclitaxel + cisplatin treatment regimen [OR = 4. 129,95% CI(2. 019,8. 444),P < 0. 001],treatment cycle more than four cycles [OR = 9. 689,95% CI(1. 799,52. 177),P = 0. 016] were independent risk factors,and enteral nutrition support [OR = 0. 143,95% CI(0. 035,0. 579),P = 0. 009] were independent protective factors. The irrational rate of prophylactic use of rhG-CSF was 31. 58%(6/19).ConclusionAdvanced age (≥ 65 years old),cisplatin-based treatment scheme and long treatment cycle(more than four cycles) are independent risk factors for neutropenia in nasopharyngeal carcinoma patients treated by paclitaxel combined with platinum-based concurrent chemoradiotherapy,while enteral nutrition support is an independent protective factor. The rationality of clinical prophylactic use of rhG-CSF in this hospital needs to be improved.
作者
李滇
汪旭
鲁小敏
LI Dian;WANG Xu;LU Xiaomin(Hai'an People's Hospital,Nantong,Jiangsu,China 226600)
出处
《中国药业》
CAS
2022年第24期111-115,共5页
China Pharmaceuticals
基金
江苏省卫生健康委科研项目[Z2021090]。
关键词
鼻咽癌
中性粒细胞减少
紫杉醇
铂类
同步放化疗
影响因素
重组人粒细胞刺激因子
nasopharyngeal carcinoma
neutropenia
paclitaxel
platinum
concurrent chemoradiotherapy
influencing factors
recombinant human granulocyte stimulating factor
