草酸铂神经毒性的防治  

Prevention and treatment of oxaliplatin induced neurotoxicity

作　　者：何敬东[1] 岳顺[1] 陈小飞[1] 贾正飞[1] 刘扬清[1] 潘池[1] 朱锦绣[1] 易竹筠[1] 

机构地区：[1]南京医科大学附属淮安一院肿瘤科,江苏淮安223300

出　　处：《中国肿瘤临床与康复》2004年第4期324-325,共2页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的评价卡马西平、葡萄糖酸钙防治草酸铂神经毒性的疗效。方法草酸铂130mgm2,静滴,第1天;醛氢叶酸(CF)200mgm2,静滴,第1～5天;5Fu300mgm2,静滴,第1～5天。21d为1周期。60例大肠癌患者随机分成3组,每组20例。分别观察卡马西平组(A组)、葡萄糖酸钙防治组(B组)、对照组(C组)的草酸铂神经毒性。结果A组、B组、C组的草酸铂神经毒性发生率分别为45.0%、50.0%和85.0%。A组神经毒性Ⅰ级9例,B组神经毒性Ⅰ级9例、Ⅱ级1例,C组神经毒性1级14例、Ⅱ级2例、Ⅲ级1例,其中C组3例累积剂量神经毒性用卡马西平治疗缓解,平均累积剂量A、B、C组分别为720mgm2、650mgm2和480mgm2,A、B组与C组的神经毒性发生率比较差异有显著性(P<0.05)。结论卡马西平、葡萄糖酸钙可以减少草酸铂的神经毒性发生,缓解神经毒性症状,增加累积剂量,值得进一步研究。Objective To study the clinical effect of carbamazepine and calcium gluconate on oxaliplatin(L OHP) induced neurotoxicity.Methods L OHP 130 mg/m 2,ivgtt,on day 1;leucovorin(CF)200 mg/m 2,ivgtt,from day 1 to day 5;5 Fu 300 mg/m 2,ivgtt,from day 1 to day 5;21 days for each cycle.Sixty advanced colorectal cancer patients were randomly divided into A,B and C groups and every group had 20 patients.The patients of groups A and B received carbamazepine 300 mg/d,calcium gluconate 3 g/d,respectively.The group C was control group.Before and after chemotherapy,all patients were evaluated for peripheral sensory neurotoxicity and rated according to the oxaliplatin specific scale.Results The incidence of oxaliplatin induced neurotoxicity of the group A,B and C was 45.0%,50.0%,85.0%( P <0.05) respectively and the median cumulative oxaliplatin dose was 720 mg/m 2,650 mg/m 2,480 mg/m 2 respectively.Grade Ⅰ neurotoxicity appeared 9,9 and 14 cases of the groups A,B and C respectively.Grade Ⅱ neurotoxicity appeared 1 and 2 cases of the groups B and C respectively.Grade Ⅲ neurotoxicity appeared in one case of the group C.Carbamazepine relieved the symptoms of three cases of neuropathy induced by cumulative dose of oxaliplatin in the group C.The rate of neurotoxicity in patients of groups A or B was significantly different from that of group C( P <0.05).Conclusion Carbamazepine,the sodium channel blocker,and calciumion may be effective in preventing and overcoming oxaliplatin induced neurotoxity.

关 键 词：结直肠肿瘤 草酸铂 神经毒性 卡马西平 葡萄糖酸钙 

分 类 号：R735.3[医药卫生—肿瘤] R730.53[医药卫生—临床医学]