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目的探讨卡铂联合多西他赛化疗与晚期乳腺癌患者粒细胞缺乏症伴发热的关系。方法采用卡铂和多西他赛联合治疗方案治疗晚期乳腺癌患者132例。按照疗程和剂量分为四组:高剂量延长疗程组(HDLC组,36例);正常剂量延长疗程组(NDLC组,31例);高剂量正常疗程组(HDNC,27例);正常剂量正常疗程组(NDNC,38例)。比较四组粒细胞缺乏症伴发热的发生率,分析疗程或剂量与其发生的相关性。结果 HDLC组、NDLC组和HDNC组的粒细胞缺乏症伴发热的发生率均高于NDNC组(38.89%、29.03%和40.74%vs.21.05%)(P<0.05),HDNC组高于NDLC组(P<0.05)。疗程和剂量与粒细胞缺乏症伴发热相关性的Logistic回归分析显示,延长疗程导致粒细胞缺乏症伴发热的发生率是正常疗程的1.316倍(95%CI=1.102-1.530,P<0.05);高剂量导致粒细胞缺乏症伴发热的发生率是正常剂量的2.128倍(95%CI=1.782-2.474,P<0.05)。结论延长疗程和加大剂量可增加化疗导致粒细胞缺乏症伴发热的发生率。
Objective To investigate the relationship between carboplatin and docetaxel chemotherapy in patients with advanced breast cancer and agranulocytosis with fever. Methods A total of 132 patients with advanced breast cancer were treated with combination of carboplatin and docetaxel. According to the course of treatment and the dosage, the patients were divided into four groups: high dose extended course group (HDLC group, 36 cases), normal dose extended course group (NDLC group, 31 cases), high dose normal course group (HDNC, 27 cases) Treatment group (NDNC, 38 cases). The incidence of agranulocytosis versus fever in the four groups was compared and the correlation between course of treatment and dose was analyzed. Results The incidence of agranulocytosis with HDLC, NDLC and HDNC were significantly higher than those with NDNC (38.89%, 29.03% and 40.74% vs.21.05%, respectively) (P <0.05) (P <0.05). Logistic regression analysis showed that the incidence of agranulocytosis with prolonged course of treatment was 1.316 times higher than that of normal course (95% CI = 1.102-1.530, P <0.05). The high incidence of agranulocytosis with fever resulted in 2.128 times the normal dose (95% CI = 1.782-2.474, P <0.05). Conclusion Extending the course of treatment and increasing the dose can increase the incidence of agranulocytosis with fever.