| Objective: To analyze the related factors of bone marrow suppression caused by chemotherapy in three common malignant tumors of gynecology(cervical cancer,endometrial cancer,ovarian cancer),and to explore the related risk factors,so as to provide relevant reference data for clinical prevention and treatment.Method: Clinical data of 155 inpatients who were diagnosed with cervical cancer,endometrial cancer or ovarian malignant tumors during the January 2017-January 2019 period and who received chemotherapy at the First Hospital of Lanzhou University were collected and retrospectively analyzed.All patients were divided into three groups according to the myelosuppression grading index of common toxic side effects of anticancer drugs of the World Health Organization: no bone marrow suppression group(grade 0),mild myelosuppression group(grade I,II)and severe myelosuppression Group(Class III,IV).All data were analyzed using the SPSS 22.0 software package,and one-way ANOVA was used for comparison between continuous measures that were normally distributed.The non-parametric Kruskal-Wallis H test method was used for the difference between the continuous measurement indicators and the comparison of the normal distribution;the difference between the groups was compared to select the chi-square test.After univariate analysis,relevant indicators affecting myelosuppression were extracted and Logistic regression analysis was performed to detect independent influencing factors affecting the severity of myelosuppression.Result:(1)The incidence of no myelosuppression was 25.8%;the incidence of grade III and IV myelosuppression was 26.5%;the incidence of grade I and II myelosuppression was 47.7%;and the incidence of total myelosuppression was 74.2%.(2)The non-myelosuppressive group and the severe group were most distributed in the 50-59 age group,and the mild group was the most distributed in the 40-49 age group.(3)Body surface area was statistically different between different degrees of myelosuppression(P<0.05).The total number of chemotherapy was statistically significant(P<0.01).(4)Age(?60 years old),surgical method was statistically significant in the presence or absence of myelosuppression group(P<0.05);BMI(?25),tumor type,tumor stage,and the most severe time of bone marrow suppression was located in total chemotherapy.The fourth or more cycles(expressed by M ? 4)were statistically significant(P<0.01)in the presence or absence of myelosuppression.(5)Chemotherapy regimen,tumor stage,and “M?4” were statistically significant between the severe and mild myelosuppressive groups(P<0.05),including tumor stage,“M?4” in the mild myelosuppression group and severe myelosuppression.The difference between the groups was significant(P<0.01).(6)Multivariate logistic regression analysis showed that tumor stage(stage II),surgical procedure(open surgery),“M?4” and total chemotherapy frequency were independent risk factors for the severity of bone marrow suppression(P<0.05,OR>1),and BSA and tumor stage(stage I)were protective factors for the severity of myelosuppression(P<0.05,OR<1).Conclusion:Platinum combined chemotherapy has a high incidence of myelosuppression,and whether there are factors affecting myelosuppression Age(?60 years),surgical procedure,tumor type,tumor stage,total number of chemotherapy,"M ?4".The relevant influencing factors between the degree of myelosuppression were chemotherapy regimen,tumor stage(stage I and II),surgical procedure,“M?4”,BSA,and total number of chemotherapy.Tumor staging(stage II),surgical procedure(open surgery),"M ?4" and total chemotherapy frequency are independent risk factors for the severity of myelosuppression;when the tumor stage is stage I,the degree of myelosuppression is low,with BSA Increase,the degree of myelosuppression is reduced.The results of this study can provide reference evidence for the development of clinical preventive measures for the future of gynecology in the First National Hospital of Lanzhou. |
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