摘要
目的:观察和分析奥沙利铂治疗可切除结直肠癌相关的神经毒性发生及恢复情况。方法:应用奥沙利铂辅助治疗结直肠癌93例,分析急慢性神经毒性与患者临床资料及治疗方案的关系,应用NTX-12自评量表对患者长期遗留神经毒性进行随访和分析。结果:急性神经毒性发生率为47.3%(44/93),其中3级毒性1.1%(1/93);慢性神经毒性具有明显的剂量累积性,总体发生率为82.8%(77/93),其中3级毒性15.1%(14/93);急性和慢性神经毒性之间无相关性;年龄≥60岁老年患者较<60岁患者慢性神经毒性发生率更高,程度更为严重(95.2%vs.72.5%,P=0.014),但前者治疗前NTX-12自评得分也明显更高(2.45vs.0.47,P<0.001);治疗结束后6个月41.9%(39/93)患者遗留神经毒性,其中3级2.2%(2/93),12个月后28.0%(26/93)患者遗留神经毒性,3级仅1例(1.1%);FOLFOX4方案和mFOLFOX6方案间神经毒性差异无统计学意义。结论:奥沙利铂治疗结直肠癌神经毒性发生率高,多数可在12个月内恢复,对患者需加强随访和医疗指导,进一步提高用药安全性。
Objective： This work aimed to observe and analyze oxaliplatin-related neurotoxicity in patients with resectable colorectal cancer. Methods： Ninety-three patients with resectable colorectal cancer received adjuvant chemotherapy with oxaliplafin. The incidence and severity of neurotoxicity was recorded. The correlation of acute and chronic neurotoxicity with clinical characteris- tics and chemotherapeutic regimens was analyzed. A 12-item neurotoxicity questionnaire （NTX-12） was used for a long-term assess- ment of whether and how excess neurotoxicity persists. Results： Through completion of the treatment, 47.3% of the patients developed acute neurotoxicity, but severe （grade 3） acute neurotoxicity was rare （1.1%）. The incidence of chronic neurotoxicity was fairly high, with 82.8% of patients developing chronic neurotoxicity, whereas severe （grade 3） chronic neurotoxicity was common （l 5. 1%）. Chron- ic neurotoxicity was evidently correlated with the cumulative dose of oxaliplatin administration. Acute neurotoxicity was not correlated to chronic neurotoxicity. Chronic neurotoxicity was more common and serious in senior patients （95.2% vs. 72.5%, P=0.014）. Moreover, NTX-12 score before treatment was also higher in senior patients （2.45 vs. 0.47, P〈0.001）. Six months after the end of treatment, 41.9% of the patients suffered neurotoxicity of various grades, with two patients （2.2%） reporting grade 3. Twelve months after treat- ment, grades 1 to 2 and grade 3 neurotoxicity were observed in 28% and 1.1% of patients, respectively. As regards neurotoxicity, the mFOLFOX6 regimen was found to be similar to FOLFOX4. Conclusion： Oxaliplatin-related neurotoxicity is rather common. Most pa- tients suffering neurotoxicity could recover within 12 months. Intensive follow up and medical advice would be necessary to improve medication safety further.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2013年第12期725-729,共5页
Chinese Journal of Clinical Oncology
关键词
奥沙利铂
神经毒性
结直肠癌
辅助化疗
oxaliplatin
neurotoxicity
colorectal cancer
adjuvant chemotherary
