甲钴胺预防乳腺癌患者多西紫杉醇化疗导致外周神经毒性的研究被引量：21

Study on Methylcobalamin in Preventing Docetaxel Chemotherapy-induced Peripheral Neurotoxicity in Patients with Breast Cancer

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摘要目的观察甲钴胺预防和治疗乳腺癌患者多西紫杉醇化疗导致周围神经毒性的作用。方法将88例行多西紫杉醇化疗的乳腺癌患者,随机分为甲钴胺治疗组和对照组。甲钴胺治疗组化疗每周期同时给予甲钴胺500μg/d,1次/天,共7天;在治疗前、化疗每周期后分别记录临床感觉神经系统症状,并记录周围神经毒性级别。有神经毒性症状的患者化疗结束后每2月随访1次,共随访6月。结果 (1)治疗组周围神经毒性总发生人数为14人,Ⅰ度、Ⅱ度、Ⅲ度毒性反应分别10、4、0人;对照组周围神经毒性总发生人数为23人,Ⅰ度、Ⅱ度、Ⅲ度毒性反应分别13、8、2人。治疗组较对照组神经毒性总发生率(23人)和神经毒性严重程度明显降低。(2)治疗组发生外周神经毒性反应时间平均为(16.4±5.2)周,多西紫杉醇用量为(315.8±38.2)mg,较对照组发生时间(9.8±3.2)周明显滞后,并且发生最初神经毒性症状时的多西紫杉醇用量(210.8±29.2)mg明显增加。(3)甲钴胺组外周神经毒性完全恢复时间为6周期化疗后4月,对照组为结束后6月。两者平均神经毒性恢复时间没有差异。结论化疗同时联合甲钴胺使用能有效预防和减低乳腺癌患者多西紫杉醇导致的外周神经毒性。 Objective To investigate the role of Methylcobalamin in prevention and treatment of chemo- therapy-induced peripheral neurotoxicity（CIPN）in patients with breast cancer by doeetaxel. Methods 88 patients with breast cancer by docetaxel chemotherapy were randomly divided into Methylcobalamin treatment group and control group. 45 patients were entered in Methylcobalamin treatment group and 43 patients in control group. The Methylcobalamin treatment group patients received Methylcobalamin 500fig with NS 100ml per day for 7 days from the first day treated with docetaxel. The clinical sensory nervous system symptoms and the level of peripheral nerve toxicity were recorded before chemotherapy, after chemotherapy per week. 6 months follow-up of patients with symptoms of neurotoxicity were carried out. Results The incidence and severity of CIPN were reduced more significantly in Methylco/Jalamin treat ment group than in control group. The average beginning of peripheral neurotoxicity reaction time in Methylcobalamin treatment group were（ 16.4 ± 5.2）weeks with docetaxel dosage of（315.8±38.2）mg and lagged far behind that in control group, which were （9. 8 ± 3. 2） weeks with docetaxel dosage of （210.8± 29.2）mg. No significantly difference was found on the time of peripheral neurotoxicity fully re stored between two groups. Conclusion Chemotherapy combined Methylcobalamin effectively prevented CIPN in breast cancer patients treated by docetaxel.

作者赵艳霞程晶朱芳吴红革陈胜

机构地区华中科技大学同济医学院附属协和医院肿瘤中心

出处《肿瘤防治研究》 CAS CSCD 北大核心 2012年第12期1487-1490,共4页 Cancer Research on Prevention and Treatment

关键词乳腺癌化疗导致外周神经毒性多西紫杉醇甲钴胺 Breast cancer Chemotherapy-induced peripheral neurotoxicity Docetaxel Methylcobalamin

分类号 R737.9 [医药卫生—肿瘤]

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