Factors Associated with Hypersensitivity Reactions in Patients Receiving Paclitaxel at Lop Buri Cancer Hospital

Abstract

Background: The chemotherapy drug paclitaxel can cause hypersensitivity reactions. Objective: To study the occurrence of hypersensitivity reactions and the factors associated with hypersensitivity in cancer patients who received paclitaxel. Method: The research was a retrospective observational study. The sample group was cancer patients who received paclitaxel between January and December 2022. Two groups: the group that received paclitaxel and had hypersensitivity, 50 times, and the group that did not had hypersensitivity, simple randomly selected from those did not had hypersensitivity in every treatment cycle 50 times. A total of 100 samples were collected. Result: A total of 2,472 cancer patients treated with paclitaxel between January and December 2022. Hypersensitivity had 50 times (2.02%). Most of them were grade 1, 2. Common symptoms were shortness of breath (76%), swelling of the face, redness, itching (50%), back pain and chest pain (26%). The factors associated with hypersensitivity, statistically significant factors were found: who received the drug in the 2nd cycle (p < .001), concentrations 1-1.49 mg/ml (p = .005), taken dexamethasone 8 mg tab at 22.00 p.m. and 6:00 a.m. before administering chemotherapy (p = .008) and a mixture of drugs less than 30 minutes before starting the injection (p < .001). Conclusion: To reduce the severity of hypersensitivity, resulting in safe patients until completion of the treatment plan. Patients receiving concentrations of more than 1 mg/ml in the first 3 cycles of treatment should be closely monitored during the first 20 minutes of treatment. When paclitaxel is mixed with normal saline, shake and waited at least 30 minutes for the drug to mix into a clear solution before administering it. Patients had no need to receive premedication with dexamethasone 8 mg tab at 22.00 p.m. and 6:00 a.m. before administering chemotherapy because it did not help reduce the occurrence of hypersensitivity reactions.