Abstract：
UNASSIGNED: Paclitaxel hypersensitivity reactions (HSRs) are prevalent, especially in females. The common paclitaxel pretreatment, dexamethasone, may inhibit chemotherapy efficacy and accelerate tumor progression. We aimed to balance paclitaxel HSRs and the lowest dexamethasone dose for gynecologic malignancies.
UNASSIGNED: We retrospectively examined 1,074 cycles of 3-weekly paclitaxel-containing treatment for 231 gynecologic malignancies at Xiangya Hospital. HSR incidence with different dexamethasone regimens was the primary outcome. Risk factors were examined in all cycles using univariate and multivariate models with generalized estimating equations. A subgroup analysis of initial exposure to paclitaxel was also conducted.
UNASSIGNED: HSR occurred in 33 patients (14.29%) and 49 cycles (4.56%), including 69.39% in cycles 1-2. There were no severe HSRs (grade ≥3). Different premedication regimens, including dexamethasone dosage and route, ranitidine presence or absence, didn\'t affect HSR incidence in univariate and multivariate analyzes (p > 0.05). Premenopausal women exerted fewer HSRs (ORadj 0.22, 95%CI 0.08-0.58; p = 0.002). At the first exposure to paclitaxel, more than 10 mg of dexamethasone didn\'t diminish HSRs (OR 0.83, 95%CI 0.27-2.59; p = 0.753).
UNASSIGNED: In gynecologic malignancies, 10 mg dexamethasone along with 20 mg diphenhydramine may be adequate to prevent paclitaxel HSRs without ranitidine. It is necessary to reevaluate paclitaxel premedication regimens.
UNASSIGNED: We retrospectively examined 1,074 cycles of 3-weekly paclitaxel-containing treatment for 231 gynecologic malignancies at Xiangya Hospital. HSR incidence with different dexamethasone regimens was the primary outcome. Risk factors were examined in all cycles using univariate and multivariate models with generalized estimating equations. A subgroup analysis of initial exposure to paclitaxel was also conducted.
UNASSIGNED: HSR occurred in 33 patients (14.29%) and 49 cycles (4.56%), including 69.39% in cycles 1-2. There were no severe HSRs (grade ≥3). Different premedication regimens, including dexamethasone dosage and route, ranitidine presence or absence, didn\'t affect HSR incidence in univariate and multivariate analyzes (p > 0.05). Premenopausal women exerted fewer HSRs (ORadj 0.22, 95%CI 0.08-0.58; p = 0.002). At the first exposure to paclitaxel, more than 10 mg of dexamethasone didn\'t diminish HSRs (OR 0.83, 95%CI 0.27-2.59; p = 0.753).
UNASSIGNED: In gynecologic malignancies, 10 mg dexamethasone along with 20 mg diphenhydramine may be adequate to prevent paclitaxel HSRs without ranitidine. It is necessary to reevaluate paclitaxel premedication regimens.
摘要：
■紫杉醇超敏反应（HSR）很普遍，尤其是女性。常见的紫杉醇预处理,地塞米松,可能抑制化疗疗效并加速肿瘤进展。我们旨在平衡紫杉醇HSR和妇科恶性肿瘤的最低地塞米松剂量。
■我们在湘雅医院对231例妇科恶性肿瘤进行了1,074个周期的含紫杉醇3周治疗。不同地塞米松方案的HSR发生率是主要结果。使用具有广义估计方程的单变量和多变量模型在所有周期中检查风险因素。还进行了对紫杉醇初始暴露的亚组分析。
■33例（14.29%）和49个周期（4.56%）发生HSR，其中1-2周期为69.39%。没有严重的HSR（≥3级）。不同的术前用药方案,包括地塞米松的剂量和给药途径,雷尼替丁的存在或不存在，单因素和多因素分析均不影响HSR的发病率(p>0.05)。绝经前妇女的HSR较少（ORadj0.22，95CI0.08-0.58；p=0.002）。第一次接触紫杉醇时，超过10mg的地塞米松不会减少HSR（OR0.83，95CI0.27-2.59；p=0.753）。
■在妇科恶性肿瘤中，10mg地塞米松和20mg苯海拉明可能足以预防不含雷尼替丁的紫杉醇HSR。有必要重新评估紫杉醇的前用药方案。
■我们在湘雅医院对231例妇科恶性肿瘤进行了1,074个周期的含紫杉醇3周治疗。不同地塞米松方案的HSR发生率是主要结果。使用具有广义估计方程的单变量和多变量模型在所有周期中检查风险因素。还进行了对紫杉醇初始暴露的亚组分析。
■33例（14.29%）和49个周期（4.56%）发生HSR，其中1-2周期为69.39%。没有严重的HSR（≥3级）。不同的术前用药方案,包括地塞米松的剂量和给药途径,雷尼替丁的存在或不存在，单因素和多因素分析均不影响HSR的发病率(p>0.05)。绝经前妇女的HSR较少（ORadj0.22，95CI0.08-0.58；p=0.002）。第一次接触紫杉醇时，超过10mg的地塞米松不会减少HSR（OR0.83，95CI0.27-2.59；p=0.753）。
■在妇科恶性肿瘤中，10mg地塞米松和20mg苯海拉明可能足以预防不含雷尼替丁的紫杉醇HSR。有必要重新评估紫杉醇的前用药方案。
