文拉法辛预防奥沙利铂所致神经毒性的临床观察  

Assessment of the protective effect of venlafaxine on oxaliplatin-induced neurotoxicity

作　　者：宋敏[1] 李磊[1] 常志伟[1] 孟宇[1] 畅捷[1] 

机构地区：[1]郑州大学第一附属医院肿瘤科,河南郑州450052

出　　处：《中华肿瘤防治杂志》2013年第7期546-549,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：河南省教育厅科学技术研究重点项目(12A320048)

摘　　要：目的:探讨文拉法辛对奥沙利铂所致神经毒性的预防作用。方法:将103例接受含奥沙利铂方案化疗的恶性肿瘤患者随机分成文拉法辛组(58例)和对照组(45例),文拉法辛组(随机分为A、B两组)化疗同时给予口服文拉法辛,其中A组28例给予文拉法辛37.5mg,1次/d,B组30例给予文拉法辛75.0mg,1次/d,对照组化疗同时给予口服安慰剂。按照NCI-CTC 3.0奥沙利铂神经毒性分级标准,观察不同组别急、慢性神经毒性以及不良反应发生的差异。结果:A组急性神经毒性的发生率(57.1%)稍高于B组(56.7%),但A、B两组均明显低于对照组的80.0%,A组与对照组发生率比较差异有统计学意义,P=0.036;B组与对照组发生率差异有统计学意义,P=0.03;而A组与B组发生率差异无统计学意义,P=0.971。化疗3个周期时,A组、B组和对照组Ⅰ～Ⅱ度神经毒性的发生率分别为35.7%、40.0%和42.4%,差异无统计学意义,P>0.05。化疗6个周期时,A组Ⅰ～Ⅱ度神经毒性发生率为48.0%,低于B组的53.6%,差异无统计学意义,P=0.685;而A组慢性神经毒性发生率低于对照组的76.9%,差异有统计学意义,P=0.017;B组慢性神经毒性发生率低于对照组,差异有统计学意义,P=0.022。化疗9个周期时,A组慢性神经毒性发生率为59.1%低于B组的62.5%,但差异无统计学意义,P=0.813;而A组Ⅰ～Ⅱ度神经毒性发生率低于对照组的87.9%,差异有统计学意义,P=0.027。B组慢性神经毒性发生率低于对照组,差异有统计学意义,P=0.046。A、B两组恶心、呕吐、乏力不良反应的发生率均较对照组明显增多,差异有统计学意义,P<0.05。结论:文拉法辛能明显减少奥沙利铂所致急慢性神经毒性发生。OBJECTIVE： To observe the therapeutic effect of Venlafaxine for oxaliplatin-induced neurotoxicity. METHODS： A total of 103 cases with Oxaliplatin combined chemotherapy were randomly divided into control group, treatment group A （n28,37.5 rag, 1 f/d） and B（n= 30,75.0 mg, 1 f/d）：the control group was treated with placebo; the treatment group A and B were treated with Venlafaxine prior to chemotherapy. The incidence of oxaliplatin-induced neurotoxicity and adverse reactions of Venlafaxine were observed. RESULTS： The incidence of acute neurotoxicity for the treatment group A, B and the control group were 57.1%, 56.7 % and 80.0%, respectively. The incidence of acute neurotoxici- ty was statistically significant between the A group and the control group,P=0. 036% the incidence of acute neurotoxicity was statistically significant between the B group and the control group,P= 0.03; but no statistically significant difference between the A group and the B group,P=0. 971. At the third cycle,the incidence of grade I -- Ⅱ chronic neurotoxicity for the treatment group A,B and the control group were 35.7% ,40.0% and 42.4% respectively,and there was no statis- tically significant difference （P〈0.05）. After 6 cycles the incidence of grade I --Ⅱ chronic neurotoxicity for the treatment group A, B and the control group were 48.0 % and 53.6 %, respectively. The incidence of chronic neurotoxicity was statistically significant between the A group and the control group （P= 0. 017）, between the B group and the control group （P=0. 022）, and between A and B group （P=0. 685）. After 9 cycles,the incidence of grade I -- Ⅱ chronic neurotoxicity for the treatment group A,B and the control group were 59.1 %, 62.5 % and 87.9 %, respectively. The difference was statistically significant between A and control group （P〈0. 027） ,between A and B group （P=0. 813） and between B and control group （P=0. 046）. The main adverse events in venlafaxine were asthenia, nausea and vomiting which were more freq

关 键 词：文拉法辛 奥沙利铂 神经毒性 药物疗法 预防 

分 类 号：R730.5[医药卫生—肿瘤]