Clinical analysis of anaphylaxis in chemotherapy of paclitaxel in cancer patients

Objective To analyze the causes of the anaphylaxis of paclitaxel in the chemotherapy of cancer patients, and discuss the reasonable treatment measures that can be taken in clinic. Methods In 2017 in the cancer ward of Hangzhou Tumor hospital, the data of lung cancer patients who were treated with paclitaxel were analyzed retrospectively. A total of 223 patients were included, including 130 males and 93 females. The age ranged from 43 to 71 years old, and the average was (57.6±6.4) years old. There were 120 cases of central lung cancer and 103 cases of peripheral lung cancer. The pathological types were squamous cell carcinoma in 124 cases, adenocarcinoma in 84 cases, and squamous cell carcinoma in 15 cases. All the patients were used with paclitaxel for the first time, without any history of allergy. According to the manufacturer's instructions, the drug pretreatment (dexamethasone + diphenhydramine +cimetidine) was made before the treatment of Paclitaxel. Methods of paclitaxel administration:dosage 135-175 mg/m², intravenous infusion, at the first days of chemotherapy, or docetaxel 75 mg/m², intravenous infusion, at the first days of chemotherapy, 4 weeks for 1 course, and chemotherapy was for 4-6 courses. The data of medical records were collected, and the anaphylaxis of paclitaxel preparations in chemotherapy of tumor patients was analyzed. The causes and preventive measures for clinical application were discussed. Results The main reasons for anaphylaxis in paclitaxel chemotherapy were:inappropriate infusion set, lack of paclitaxel medication, mental stress and allergic constitution. Conclusion The standardization of paclitaxel can prevent and reduce the occurrence of anaphylaxis. Monitoring and standardizing the allergic reaction can improve the safety of paclitaxel chemotherapy.