| Author/Editor | Dobravc Verbič, Matej; Homec, Kristina; Mrhar, Aleš; Štabuc, Borut; Janša, Rado; Šmid, Alojz | |
| Title | Ocena pojavnosti in pregled prilagoditev zdravljenja ob hematoloških neželenih učinkih pri gastro-onkoloških bolnikih zdravljenih z intravensko kemoterapijo v Univerzitetnem kliničnem centru Ljubljana | |
| Translated title | Assessment of incidence and management of haematologic toxicity in gastrointestinal cancer patients receiving intravenous chemotherapy at the University Medical Centre Ljubljana | |
| Type | članek | |
| Vol. and No. | Letnik 20, št. 1 | |
| Publication year | 2016 | |
| Volume | str. 12-21 | |
| ISSN | 1408-2756 - Gastroenterolog : revija slovenske gastroenterološke sekcije | |
| Language | slv | |
| Abstract | Izhodišča: Pravilno ukrepanje ob pojavu hematoloških neželenih učinkov pri zdravljenju s kemoterapijo je pomembno za doseganje optimalnih izidov zdravljenja. Namen raziskave je bil pridobiti oceno pojavnosti hematoloških neželenih učinkov pri bolnikih, zdravljenih z intravensko kemoterapijo v gastro-onkološki ambulanti, in primerjati njihovo obravnavo s tujimi priporočili. Metode: Opravili smo retrospektivno raziskavo bolnikov s hematološkimi neželenimi učinki, zdravljenih v gastro-onkološki ambulanti Univerzitetnega kliničnega centra Ljubljana v letu 2012. Spremljali smo prilagajanje odmerkov in zamike aplikacij intravenske kemoterapije. Rezultati: V raziskavo je bilo vključenih 121 bolnikov. Hematološki neželeni učinki so se pojavili pri 73 bolnikih (60,3 %); anemija pri 52 (42,9 %), levkopenija pri 41 (33,9 %), nevtropenija pri 33 (27,3 %) in trombocitopenija pri 25 bolnikih (20,6 %). Pojavnost anemije in trombocitopenije je bila primerljiva s pojavnostjo v nekaterih podobnih raziskavah, pojavnost nevtropenije pa je bila v naši raziskavi nižja. Glede na tuja priporočila je bila prilagoditev terapije (znižanje odmerka in/ali zamik aplikacije) potrebna pri 24/121 bolnikih (19,8 %), skupno za 64/623 (10,3 %) intravenskih aplikacij kemoterapije. Ustrezne prilagoditve zdravljenja ni bilo pri 25/64 aplikacijah kemoterapije (39,1 %). Zaključki: Pojavnost hematoloških neželenih učinkov pri gastro-onkoloških bolnikih, zdravljenih v gastro-onkološki ambulanti, je bila v splošnem primerljiva s podatki podobnih raziskav. Visok delež intravenskih aplikacij kemoterapije, ki niso bile prilagojene v skladu s tujimi priporočili, nakazujejo potrebo po izdelavi internih priporočil za ravnanje ob pojavu hematoloških neželenih učinkov in po pregledu predpisane kemoterapije s strani kliničnega farmacevta glede na laboratorijske izvide hematoloških parametrov, za kar bi bila potrebna dodatna računalniška podpora.Background: Correct management of haematologic toxicity as a side effect of chemotherapy is essential to achieve optimal treatment outcomes. The aim of the study was to assess the incidence of haematologic toxicity in ambulatory patients with gastrointestinal cancer receiving intravenous chemotherapy and make a comparison with existing international guidelines. Methods: A retrospective study was performed in patients with gastrointestinal cancer, treated at the ambulatory clinic of the University Medical Centre Ljubljana in 2012, who developed haematologic toxicity. Dose adjustments and treatment delays were reviewed for included patients. Results: 121 patients were included in the study. Haematologic toxicity occurred in 73 (60.3%) patients; 52 (42.9%) patients presented with anaemia, 41 (33.9%) with leukopenia, 33 (27.3%) with neutropenia, and 25 (20.6%) with thrombocytopenia. Incidences of anaemia and thrombocytopenia were comparable to those from similar foreign studies, while incidence of neutropenia in our study was lower. According to international guidelines, treatment adjustments (dose reductions and/or treatment delays) were required in 24/121 (19.8%) patients, for 64/623 (10.3%) chemotherapy administrations altogether. 25/64 (39.1%) administrations were not adjusted according to guidelines. Conclusions: Incidence of haematologic toxicity in gastrointestinal cancer patients treated at the ambulatory clinic was generally comparable to similar foreign studies. High number of treatment administrations not adjusted according to the international guidelines demonstrated the necessity to create internal guidelines for the management of haematologic toxicity, and the necessity of clinical pharmacist%s review of prescribed chemotherapy together with haematological parameters % a measure which would require additional technological support. | |
| Descriptors | Kemoterapija | |
| Keywords | hematološki neželeni učinki gastro-onkološki bolniki levkopenija nevtropenija trombocitopenija anemija sistemsko zdravljenje raka |