75岁以上癌症患者免疫治疗相关不良反应的回顾性分析
DOI:
作者:
作者单位:

南京医科大学第一附属医院

作者简介:

通讯作者:

中图分类号:

基金项目:

国家自然科学基金项目(面上项目,重点项目,重大项目)


Retrospective analysis of immunotherapy related adverse events in in elderly cancer patients over 75-years-old
Author:
Affiliation:

The First Affiliated Hospital of Nanjing Medical University

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:探讨75岁以上老年人使用免疫检查点抑制剂的不良反应以讨论免疫衰老以及老年癌症患者的免疫治疗毒性以及相关毒性的管理。方法:收集2018 年1 月1 日至2021 年12 月31日在南京医科大学第一附属医院接受PD-1/ PD-L1 免疫检查点抑制剂治疗各类实体恶性肿瘤患者的不良反应信息,并进行回顾性分析及相关性评价。影响因素的相关性分析采用Pearson卡方检验,生存分析采用 Kaplan-Meier方法。结果:166例患者共接受910次治疗,平均接受免疫检查点抑制剂治疗5.48次。共有146例发生不同程度的不良反应,共记录462次不良反应,平均2.78次/例,不良反应发生率为87.9%,发生比例较高的不良反应有贫血 (78.9%),白细胞降低 (28.9%),中性粒细胞降低 (18.7%),血小板降低 (42.8%),高血糖 (21.7%),甲状腺功能异常(9.6%),皮质醇异常(9.6%)等。肯定和很可能与免疫检查点抑制剂相关的不良反应占总体不良反应的11.9%。发生3级及以上不良反应的有22例,占患者总数13.2%。经分析,是否存在≥ 3 个系统的合并症以及是否联用其他抗肿瘤药物对不良反应的发生率有显著性影响。结论:基于本研究数据,75岁以上老年患者免疫检查点抑制剂的不良反应与75岁以下患者相当,使用免疫检查点抑制剂并未增加严重不良事件的发生。

    Abstract:

    Abstract: Objectives: To investigate the adverse events, the immune aging and the immunotherapeutic toxicity of elderly cancer patients over 75 years old received immune checkpoint inhibitors and the management of related toxicity. Methods: The adverse events information of solid cancer patients who received pd-1/pd-l1 immune checkpoint inhibitors treated in the First Affiliated Hospital of Nanjing Medical University from January 1, 2018 to December 31, 2021 was collected and conducted retrospective analysis and correlation evaluation. Pearson's chi-square test was used for correlation analysis of influencing factors, and Kaplan-Meier method was used for survival analysis. Results: A total of 166 patients received 910 times of treatment, with an average of 5.48 times of immune checkpoint inhibitor treatment. A total of 146 cases had adverse events of different degrees, and a total of 462 adverse events were recorded, with an average of 2.78 times/case. The incidence of adverse events was 87.9%. Anemia (78.9%) and leucopenia were the adverse events with a higher proportion (28.9%), neutropenia (18.7%), thrombocytopenia (42.8%), hyperglycemia (21.7%), abnormal thyroid function (9.6%), abnormal cortisol (9.6%), etc. The positive and likely adverse events related to immune checkpoint inhibitors accounted for 11.9% of the total adverse events . There were 22 cases of grade 3 and above adverse events, accounting for 13.2% of the total number of patients. After analysis, whether there are complications of ≥ 3 systems and whether they are combined with other antitumor drugs have a significant impact on the incidence of adverse events. Conclusions: Based on the data of this study, the adverse events of immune checkpoint inhibitors in patients over 75 years old are equivalent to those in patients under 75 years old, and there is no increase in the occurrence of serious adverse events.

    参考文献
    相似文献
    引证文献
引用本文
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2022-09-02
  • 最后修改日期:2023-02-06
  • 录用日期:2023-05-10
  • 在线发布日期:
  • 出版日期: