發(fā)布時(shí)間：2018-07-01 14:56

  本文選題：抗腫瘤藥物 + 不良反應(yīng)　； 參考：《山東大學(xué)》2014年碩士論文

【摘要】：目的：探討和分析新型抗腫瘤藥物不良反應(yīng)現(xiàn)狀 方法：本文隨機(jī)選取溫州醫(yī)科大學(xué)第一附屬醫(yī)院2011年7月到2013年10月進(jìn)行化療的腫瘤患者病例500例,其中男250例,女250例,年齡范圍為10-85歲,中位年齡48歲,采用序號順序逐一選擇,其病理均經(jīng)病理組織學(xué)證實(shí),且病人均進(jìn)行了藥物化療；疾病分類,以原發(fā)腫瘤為準(zhǔn)。共涉及21種腫瘤病種,50種腫瘤藥物,51種化療方案。 結(jié)果：(1)采用聯(lián)合FOLFIRI或mIFL方案治療12例,聯(lián)合氟尿嘧啶類治療12例。同時(shí)比較單一性mFOLFOX方案治療24例。Bev(貝伐珠單抗)治療0.6-29.2個(gè)月,中位治療3.5個(gè)月。生存期計(jì)算從開始治療之日起至死亡或末次隨訪之日止。其不良反應(yīng)效果如表3-2,采用聯(lián)合治療方案的患者其不良反應(yīng)顯著減少(P0.05)。由此說明Bev(貝伐珠單抗)聯(lián)合不同化療方案治療直腸癌療效肯定,不良反應(yīng)可以耐受,且未加重化療的不良反應(yīng)。 (2)對于乳腺癌患者的治療采用依決洛單抗聯(lián)合曲妥珠單抗(方案A)與Pertuzumab(帕妥珠單抗)聯(lián)合依決洛單抗(方案B)的治療方案比較。其不良反應(yīng)效果如表3-3,采用方案A的患者其不良反應(yīng)顯著減少(P0.05),由此依決洛單抗聯(lián)合曲妥珠單抗方案治療優(yōu)于Pertuzumab(帕妥珠單抗)聯(lián)合依決洛單抗方案,能夠更好地降低患者的不良反應(yīng)發(fā)生率。 (3)隨著年齡的增加,Ⅲ-Ⅳ級惡心、嘔吐、腹瀉發(fā)生率明顯增加,50歲-70歲是不良反應(yīng)發(fā)生率高峰,病人更易發(fā)生藥物不良反應(yīng),但70歲以后不良反應(yīng)發(fā)生率又有所下降。 結(jié)論：抗腫瘤藥物不良反應(yīng)發(fā)生率高、毒副作用大,一般為劑量限制性毒性。但在有效的抗腫瘤治療過程中,化療必須規(guī)范、足量、足療程,不得隨意減量或終止或延長化療時(shí)間,所以,既要取得最佳療效,又需盡可能降低不良反應(yīng),施行個(gè)體化用藥。
[Abstract]:Objective: to investigate and analyze the current status of adverse drug reactions of new antitumor drugs: a total of 500 cancer patients, including 250 males, were selected randomly from July 2011 to October 2013 in the first affiliated Hospital of Wenzhou Medical University. 250 cases of female, aged 10-85 years, median age of 48 years, were selected one by serial number sequence, their pathology were confirmed by histopathology, and all patients underwent drug chemotherapy, and the classification of diseases was based on the primary tumor. A total of 51 chemotherapeutic regimens involving 21 kinds of oncology and 50 kinds of tumor drugs were involved. Results: (1) 12 cases were treated with FOLFIRI or mIFL regimen and 12 cases were treated with fluorouracil. At the same time, the single mFOLFOX regimen was compared in 24 cases. Bev (bevacizumab) was treated for 0.6-29.2 months, and the median treatment was 3.5 months. Survival was calculated from the beginning of treatment to the date of death or last follow-up. The adverse effects were as shown in Table 3-2, and the adverse reactions of patients with combined therapy were significantly reduced (P0.05). It is concluded that Bev (bevacizumab) combined with different chemotherapy regimens is effective in the treatment of rectal cancer, and the adverse reactions can be tolerated. The adverse effects of chemotherapy were not aggravated. (2) the treatment of breast cancer patients was compared with that of Pertuzumab and Pertuzumab combined with Etolomab (option B). The adverse effects of the treatment were as shown in Table 3-3. The adverse reactions of patients with regimen A were significantly reduced (P0.05), so that the combination of Etolomab and tritozumab was better than that of Pertuzumab combined with Evolumab. (3) with the increase of age, the incidence of grade 鈪，

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