Analysis and treatment of 45 platinum-allergic gynecologic malignant tumors
This study aimed to explore the potential risk factors of platinum allergy and follow-up treatment to provide a reference for the clinical prevention and treatment of platinum allergic reactions in patients with gynecological tumors.
The study retrospectively analyzed 45 cases of platinum allergic reactions that occurred in Shengjing Hospital affiliated to China Medical University from August 2010 to July 2016. Analysis of risk factors included the cumulative dose, treatment course and time intervals.
The cumulative carboplatin dose in allergic patients ranged from 900 to 10250 mg (average 4845 mg). The 45 allergic reactions occurred between the 3rd and 25th course of treatment (average 11.4 courses). The average re-treatment interval of carboplatin-allergic patients was 28.1 months, including 93.3% of patients with platinum re-treatment interval of more than 1 year. The allergic reaction occurred in the 2nd or 3rd course of re-treatment in 26 patients, accounting for 70.3% of all patients with recurrence. Seventeen patients were subjected to desensitization therapy, among which 13 cases were well tolerated.
Patients who received more than 8 courses of carboplatin or a cumulative dose of more than 3500 mg were the high-risk population for platinum allergy. The 2nd and 3rd treatment course after restarting carboplatin treatment after an interval time of more than 1 year was the high incident period of carboplatin allergy. Skin tests should be conducted in patients with high risk of carboplatin allergy. In cases of carboplatin allergy, patients could receive carboplatin or oxaliplatin desensitization therapy.
KeywordsPlatinum allergy Gynecologic malignant tumors Desensitization therapy High-risk scoring standard
We thank the physicians, nurses, patients and their families.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 12.Whitney CW, Sause W, Bundy BN et al (1999) Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol 17(5):1339–1348CrossRefPubMedGoogle Scholar
- 14.Alberts DS, Canetta R, Mason-Liddil N (1990) Carboplatin in the first-line chemotherapy of ovarian cancer. Semin Oncol 17(1 Suppl 2):S54–S60Google Scholar
- 15.Viswanathan AN, Moughan J, Miller BE et al (2015) NRG Oncology/RTOG 0921: a phase 2 study of postoperative intensity-modulated radiotherapy with concurrent cisplatin and bevacizumab followed by carboplatin and paclitaxel for patients with endometrial cancer. Cancer 121(13):2156–2163CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Zhang G, Li XP, Liu BJ et al (2013) Oxaliplatin-based combination chemotherapy is still effective for the treatment of recurrent and platinum-resistant epithelial ovarian cancer: results from a single center. Chin Med J (Engl) 126(23):4477–4482Google Scholar