อุบัติการณ์การเกิดภาวะภูมิไวเกินจากสูตรยาเคมีบำบัดที่มียาออกซาลิพลาตินเป็นส่วนประกอบ ภายหลังการให้ยาต้านฮีสตามีนและการยืดระยะเวลาบริหารยา : การศึกษาย้อนหลัง

Thichakarn Jhunthasiriyakorn

Authors

Thichakarn Jhunthasiriyakorn Department of Medicine, Ratchaburi Hospital, Ratchaburi

Keywords:

Oxaliplatin, FOLFOX, CAPOX, Hypersensitive reaction, Common terminology criteria for adverse events (CTCAE)

Abstract

Background: Oxaliplatin is a standard platinum agent for colorectal cancer, known for improving survival and response rates. Nonetheless, hypersensitivity reactions (HSR) occur in 12–25% of cases, posing risks to patient safety. In 2023, Ratchaburi Hospital recorded a 17.7% HSR incidence rate. To mitigate this, a new protocol using antihistamines and extended infusion times was introduced in January 2024 (commencing at cycle 7^thfor FOLFOX and cycle 5^th for CAPOX). This retrospective study aims to evaluate whether these clinical interventions effectively reduce the incidence of oxaliplatin-induced HSR.

Objective: To investigate the incidence of hypersensitivity reactions (HSRs) induced by oxaliplatin in oxaliplatin-naive patients at Ratchaburi Hospital.

Methods: This study was a retrospective descriptive study. Data were collected from the medical records of Ratchaburi Hospital, encompassing both outpatients and inpatients who received FOLFOX and CAPOX chemotherapy regimens between January 1, 2024, and December 31, 2025, at Ratchaburi Hospital.

Results: Based on data collected from outpatients and inpatients receiving FOLFOX and CAPEOX chemotherapy regimens between January 1, 2024, and December 31, 2025, at Ratchaburi Hospital, a total of 237 patients met the inclusion criteria and were included in the analysis. The findings revealed that the incidence of oxaliplatin-induced hypersensitivity reactions (HSRs) decreased from the baseline of 17.7% to 6.3%. Furthermore, the severity of the allergic reactions, graded according to CTCAE v5.0, decreased from Grades 3-4 to Grades 1-2. This reduction significantly mitigates patient safety risks associated with allergic reactions and enables patients to complete their planned treatment cycles, which ultimately contributes to better disease control and improves overall patient survival rates.

Conclusion: The administration of antihistamines combined with a prolonged infusion duration initiated at the 7^th cycle of the FOLFOX regimen and the 5^th cycle of the CAPEOX regimen in oxaliplatin-naive patients effectively reduced the incidence of oxaliplatin-induced hypersensitivity reactions (HSRs) from 17.7% to 6.3%. Furthermore, the severity of these reactions, as graded by CTCAE v5.0, was reduced from Grades 3-4 to Grades 1-2.

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