摘要
目的 分析卵巢上皮性癌患者初始治疗后发生远期骨髓抑制的影响因素。方法 回顾性分析2012年1月~2022年6月572例初始治疗的卵巢上皮性癌资料,由于时间跨度长,根据发病时间1∶3匹配2组研究样本量,初始治疗结束3个月后有骨髓抑制54例,无远期骨髓抑制组162例。比较2组年龄、体重指数、病理类型、分期、分级、化疗方案、化疗疗程、预防性使用粒细胞集落刺激因子和化疗期间发生重度骨髓抑制等情况。结果 单因素分析显示年龄、体重指数、病理类型、治疗方式、残余病灶、化疗方案、化疗疗程和预防性使用粒细胞集落刺激因子在2组间均无显著性差异(P>0.05),病理分级2~3级(OR=6.400,P=0.005)、病理分期Ⅳ期(OR=2.403,P=0.046)和化疗期间发生重度骨髓抑制≥2次(OR=2.080,P=0.020)的患者发生远期骨髓抑制的风险高;多因素分析显示化疗期间发生重度骨髓抑制≥2次(OR=1.962,95%CI:1.024~3.757,P=0.042)是发生远期骨髓抑制的独立影响因素。结论 化疗期间发生重度骨髓抑制≥2次是卵巢上皮性癌患者发生远期骨髓抑制的独立预后因素,预防性使用粒细胞集落刺激因子治疗并未降低远期骨髓抑制的发生风险。
Objective To analyze the influencing factors of the occurrence of long-term myelosuppression in patients with ovarian epithelial carcinoma after initial treatment.Methods Clinical data of 572 patients with ovarian epithelial cancer who received initial treatment from January 2012 to June 2022 were retrospectively analyzed.Due to long retrospective time,the sample size of the two groups was matched of 1∶3 according to the treatment time.The patients were divided into the long-term myelosuppression group(n=54)and the non-long-term myelosuppression group(n=162)according to whether there was myelosuppression at 3 months after initial treatment.The age,body mass index(BMI),pathological type,stage,grade,chemotherapy regimen,chemotherapy course,prophylactic use of colony stimulating factors and severe myelosuppression during chemotherapy were compared between the two groups.Results Univariate analysis showed that there were no significant differences in age,BMI,pathological type,treatment style,residual lesion,chemotherapy regimen,chemotherapy course and prophylactic use of colony stimulating factors between the two groups(P>0.05).The pathological grade 2-3(OR=6.400,P=0.005),pathological stageⅣ(OR=2.403,P=0.046),and≥2 times of severe myelosuppression during chemotherapy(OR=2.080,P=0.020)were associated with a higher risk of long-term myelosuppression.Multivariate analysis showed that≥2 times of severe myelosuppression during chemotherapy(OR=1.962,95%CI:1.024-3.757,P=0.042)was an independent influencing factor of the occurrence of long-term myelosuppression.Conclusions Occurrence of severe myelosuppression≥2 times during chemotherapy is an independent prognostic factors for long-term myelosuppression in patients with ovarian epithelial cancer after initial treatment.Prophylactic use of colony stimulating factors does not reduce the risk of long-term myelosuppression.
作者
黄翠玉
王同霞
吴章鑫
梁华茂
吴郁
郭红燕
Huang Cuiyu;Wang Tongxia;Wu Zhangxin(Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100191,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2023年第4期241-246,共6页
Chinese Journal of Minimally Invasive Surgery
基金
北京大学第三医院临床重点项目(BYSYZD2021006)。
关键词
卵巢上皮性癌
远期骨髓抑制
影响因素
Ovarian epithelial carcinoma
Long-term myelosuppression
Influencing factor
