甲钴胺联合谷胱甘肽防治消化系统肿瘤患者FOLFOX4方案化疗所致的神经毒性反应  

Preventive effect of mecobalamin combined with glutathione on neurotoxicity induced by FOLFOX4 chemotherapy

作　　者：李世东 石建华 李学记[3] 

机构地区：[1]山东省临沂市肿瘤医院临床药学室,276001 [2]山东省临沂市肿瘤医院内科,276001 [3]国家癌症中心 北京协和医学院中国医学科学院肿瘤医院肿瘤研究所神经外科,100021

出　　处：《中华肿瘤杂志》2016年第8期632-635,共4页Chinese Journal of Oncology

摘　　要：目的 分析甲钴胺联合谷胱甘肽防治消化系统肿瘤患者FOLFOX4方案化疗所致神经毒性反应的效果。方法 2012年1月至2014年8月间采用FOLFOX4方案化疗的94例消化系统肿瘤患者随机分为试验组和对照组。试验组患者化疗期间给予甲钴胺片和还原型谷胱甘肽注射液，对照组患者仅给予还原型谷胱甘肽注射液。采用1992年Levi标准进行神经毒性反应分级，观察患者用药后神经毒性反应的发生率。结果 化疗6个周期后，试验组和对照组患者的1-2级神经毒性反应发生率分别为34.7%（17/49）和55.6%（25/45），差异有统计学意义（P＝0.042）；试验组和对照组患者的3级神经毒性反应发生率分别为2.0%（1/49）和13.3%（6/45），差异有统计学意义（P＝0.037）。化疗9个周期后，试验组和对照组患者的1-2级神经毒性反应发生率分别为44.7%（21/47）和70.3%（26/37），差异有统计学意义（P＝0.019）；试验组和对照组患者的3级神经毒性反应发生率分别为4.3%（2/47）和18.9%（7/37），差异有统计学意义（P＝0.031）。结论 甲钴胺联合谷胱甘肽可显著降低消化系统肿瘤患者FOLFOX4方案化疗所致的神经毒性反应发生率及严重程度，值得临床推广应用。Objective To analyze the preventive effect of mecobalamin combined with glutathione on neurotoxicity induced by FOLFOX4 chemotherapy. Methods Ninety-four patients receiving FOLFOX4 chemotherapy between January 2012 and December 2013 were randomized into experimental group and control group. Patients in the experimental group were given mecobalamin tablets and glutathione injection during chemotherapy while the patients in control group received glutathione injection only. The status of neurotoxicity was evaluated by the Levi neurotoxicity criteria 1992. Results After six cycles of chemotherapy, the incidence of grade Ⅰ-Ⅱ neurotoxieity in the experimental and control groups were 34.7% （17/49） and 55.6% （25/45）, respectively （P = 0.042）, the incidence of grade Ⅲ neurotoxieity in the experimental and control groups were 2.0% （1/49） and 13.3% （6/45）, the difference is also statistically significant （P=0.037）. After nine cycles of chemotherapy, significantly less grade Ⅰ-Ⅱ neurotoxieity was observed in the experimental group （44.6%） than that in the control group（ 70.3%, P= 0.019）. Incidence of grade Ⅲ neurotoxieity in the experimental group was significantly lower（ 4.26% ） than that in the control group（ 18.9%, P= 0.031）. Conclusion Mecobalamin combined with glutathione can significantly reduce the incidence and severity of neurotoxicity induced by FOLFOX4 chemotherapy, therefore, worthy of clinical application.

关 键 词：消化系统肿瘤 抗肿瘤联合化疗方案 药物毒性 甲钴胺 谷胱甘肽 

分 类 号：R735[医药卫生—肿瘤]