紫杉醇简化预处理方案治疗晚期恶性肿瘤18例次临床报告  

Paclitaxel with scheme of simplify pretreatment treat advance cancer for 18 cases

作　　者：吕霞[1] 苏安[1] 王馨[1] 肖莉[1] 何英[1] 

机构地区：[1]厦门大学医学院第一临床学院厦门中山医院肿瘤科,361004

出　　处：《福建医药杂志》2002年第6期13-14,共2页Fujian Medical Journal

摘　　要：目的　为了简化紫杉醇静脉化疗预处理方案 ,提高工作效率。方法　化疗方案 :18例次均采用紫杉醇+顺铂方案 ;紫杉醇预处理方案 :于应用紫杉醇前 30分钟给予地塞米松 2 0 m g静脉点滴 ,同时给予西米替丁 30 0 mg静脉推注 ,苯海拉明 5 0 mg肌肉注射。结果　 1例膀胱浸润性移行细胞癌达到 CR,2例肺鳞状细胞癌达到 PR,1例肺腺癌 PD,1例鼻咽低分化鳞癌 PD,2例乳腺癌 PD;1例乳腺癌患者是术后辅助化疗 ,不能评价疗效。毒副反应 :(1)骨髓抑制 : 度 2例次 , 度 1例次 ,发生率 16 %。 (2 )脱发 :有 16例次出现 ,发生率 89%。 (3)关节和肌肉酸痛 :有2例次发生 ,发生率 11%。 (4)周围神经病变 :2例次出现肢端麻木。全组未出现 1例过敏反应。结论　建议在给予紫杉醇静脉化疗时 ,从第三周期起常规采用简化预处理方案 ,这样可简化患者服药次数 ,简化工作程序 。Objective Premedication with dexamethasone,diphenhydramine and cimetidine is mandatory for patients receiving paclitaxel to avoid hypersensitivity reactions.In an attempt to reduce steroid induced side effects,we reduced the dexamethasone dose to 20mg.Methods Eighteen patients with advanced cancer were treated with paclitaxel 175mg/m 2 over three hours following a short course premedication.The short course paclitaxel premedication regimens is consist of dexamethasone 20mg IV 30 minutes before paclitaxel,diphenhydramine 50mg IV 30 minutes prior to paclitaxel,and cimetidine 300mg IV 30 minutes before paclitaxel.Results The study treatment was well tolerated.3 of 18 patients(16%) experienced grade 2 or 3 neutropenia.peripheral neuropathy occurred in 2 patient.No severe hypersensitivity reactions occurred in this study.Conclusions No increase of severe hypersensitivity reactions is seen when dexamethasone premedication is reduced to doses of 20mg prior to paclitaxel infusion in the short course premedication schedule.We conclude that this premedication strategy is feasible and cost effective for patients receiving paclitaxel.

关 键 词：晚期 恶性肿瘤 紫杉醇 静脉化疗 预处理 

分 类 号：R730.52[医药卫生—肿瘤]