奥沙利铂累积剂量与蓄积性神经毒性的相关分析  

Analysis of the correlation between the neurotoxicity and the cumulative dose of oxaliplatin

作　　者：莫雪莉[1] 曹凤[1] 王德林[1] 曹玉娟[1] 杜芳[1] 孙建华[1] 刘承伟[1] 郝龙英[1] 

机构地区：[1]北京大学首钢医院肿瘤科,北京100144

出　　处：《临床肿瘤学杂志》2011年第9期817-819,共3页Chinese Clinical Oncology

摘　　要：目的观察奥沙利铂联合氟尿嘧啶和亚叶酸钙(FOLFOX 4)方案治疗胃肠道恶性肿瘤的不良反应,探讨奥沙利铂神经毒性反应的发生与累积剂量的关系。方法 114例胃肠道恶性肿瘤患者应用FOLFOX 4方案治疗,具体为:奥沙利铂85mg/m2,静滴2h,d1;亚叶酸钙200mg/m2,静滴2h,注射后立即静脉推注氟尿嘧啶400mg/m2,后予氟尿嘧啶600mg/m2,持续静滴22h,d1、d2,2周为1周期。挽救化疗患者每2个周期评价疗效,至疾病进展。辅助化疗持续6个月,观察不良反应。结果 114例患者的神经毒性反应、恶心呕吐及白细胞减少发生率较高,但均较轻微,3～4级不良反应较为少见,其中恶心呕吐发生率为7.9%,白细胞减少14.0%,血小板减少3.5%以及腹泻3.5%。奥沙利铂累积剂量在150～420mg/m2、450～800mg/m2和820～996mg/m2时,神经毒性反应的发生率分别为43.8%、89.7%和100.0%,5例累积剂量≥1008mg/m2患者中有3例出现3级神经毒性反应。结论 FOLFOX4方案化疗的不良反应较轻,其中奥沙利铂神经毒性的发生率及严重程度与其累积剂量呈正相关。Objective To analyze the side effects of oxaliplatin in combination with leucovorin and fluorouracil（FOLFOX 4） in the treatment of gastrointestinal carcinoma,and the relationship between the occurrence of neurotoxicity of oxaliplatin and the cumulative dose.Methods One hundred and fourteen patients were taken FOLFOX 4 regimen：oxaliplatin 85mg/m2,intravenous infusion 2h,d1;leucovorin 200mg/m2,intravenous infusion 2h,then following fluorouracil 400mg/m2,intravenous injection,follow-fluorouracil 600mg/m2,iv continuous infusion 22h,d1-d2.Two weeks was a cycle.The efficacy was evaluated every 2 cycles of chemotherapy for advanced patients until disease progress.Adjuvant chemotherapy were given for 6 months,and occurrence of adverse reaction was analyzed.Results The common side effects were neurological toxicity,nausea,vomiting and neutropenia.Grade 3 or 4 of nausea and vomiting,leukopenia,thrombocytopenia,diarrhea was 7.9%,14.0%,3.5% and 3.5%,respectively.When the cumulative dose of oxaliplatin was in 150-420mg/m2,450-800mg/m2 and 820-996mg/m2,the incidence of neurotoxicity was 43.8%,89.7% and 100.0% respectively.Three of 5 patients whose cumulative dose were over 1008mg/m2 occurred grade 3 neurotoxicity.Conclusion The side effects of FOLFOX 4 regimen are mild,while the incidence and grade of neurotoxicity are correlated with the cumulative dose of oxaliplatin.

关 键 词：奥沙利铂 累积剂量 神经毒性 

分 类 号：R735.2[医药卫生—肿瘤] R735.3[医药卫生—临床医学]