P067 免疫检查点抑制性结肠炎在社区医院系统中
Aaron Rampersad1, Gary Abrams2, Christina Bauer2
1University of South Carolina, School of Medicine Greenville, Greenville, South Carolina, United States.
免疫检查点抑制剂 (ICI) 大肠炎在社区环境中越来越多地被报告. 类固醇是主要的治疗方法,与学术中心相比,生物使用率较低,强调了早期胃肠科医生转诊的必要性.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 已经彻底改变了癌症治疗,但可以导致免疫相关的不良事件 (irAEs),包括结肠炎.
- 在三级医疗保健中,ICI结肠炎的记录很好,但来自社区环境的数据有限.
- 胃肠科医生在社区ICI结肠炎的管理中的作用还不清楚.
研究的目的:
- 在社区医院系统中描述免疫检查点抑制剂 (ICI) 大肠炎的临床表现和治疗结果.
- 评估在非三级保健环境中对ICI大肠炎的诊断和管理模式.
主要方法:
- 进行了单个中心的回顾性病例系列,审查了2016-2020年的患者病历.
- 使用特定的诊断代码和ICI输液记录 (pembrolizumab,nivolumab等) 来识别ICI大肠炎患者. ) 的情况.
- 抽象的数据包括人口统计,瘤类型,ICI使用,诊断方法,内镜检测结果和治疗方法.
主要成果:
- 分析了37名ICI结肠炎患者 (平均年龄为64.1岁,62%男性,100%白人).
- 黑色素瘤和非小细胞肺癌是常见的,伊皮利马布和尼沃马布是最常见的ICI.
- 类固醇是主要治疗 (64.8%),与学术中心相比,生物使用率较低 (18.9%);只有64.8%被胃肠科医生评估.
结论:
- 在社区瘤实践中,ICI结肠炎正在出现.
- 类固醇治疗是常见的,通常需要长时间的治疗,而生物使用的频率不如学术中心那么频繁.
- 在社区环境中提前转诊胃肠科医生可以改善严重ICI结肠炎的鉴定和管理,可能引导升级到生物疗法.
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