维生素B1联合甲钴胺预防肺癌患者紫杉醇化疗所致外周神经毒性的研究
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摘要
目的观察维生素B1联合甲钴胺对肺癌患者紫杉醇化疗所致外周神经毒性的预防作用。方法将72例肺癌患者随机分为观察组(36例)和对照组(36例)。对照组患者给予TP方案(紫杉醇+顺铂)进行治疗,观察组在此基础另给予维生素B1联合甲钴胺。在治疗3周期后、治疗6周期后、化疗结束2个月后及化疗结束6个月后,分别对2组患者的外周神经毒性进行评价。化疗期间,密切观察并记录2组患者出现外周神经毒性症状时的紫杉醇使用量及出现外周神经毒性症状的时间。化疗前后,检测2组腓神经与正中神经的运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)。结果治疗3周期后、治疗6周期后、化疗结束2个月后及化疗结束6个月后,观察组神经毒性发生率均明显低于对照组(P <0. 05)。治疗期间,观察组患者出现外周神经毒性的时间晚于对照组(P <0. 05),紫杉醇使用量明显大于对照组(P <0. 05)。化疗后,观察组腓神经SNCV、腓神经MNCV、正中神经SNCV及正中神经MNCV均明显高于对照组(P <0. 05)。结论化疗的同时给予维生素B1联合甲钴胺能有效预防紫杉醇所致肺癌患者外周神经毒性,值得进行深入研究。
Objective To observe the effects of vitamin B1 and mecobalamine in preventing paclitaxel chemotherapy induced peripheral nerve toxic reaction in patients with lung cancer. Methods 72 lung cancer patients were randomly divided into the observation group and the control group,36 cases in each group. The 2 groups were treated by TP regiment( paclitaxel plus cisplatin),and vitamin B1 and mecobalamine were additionally given in the observation group. The peripheral neurotoxicity of the2 groups was evaluated 3 cycles after treatment,6 cycles after treatment,2 months after cessation of chemotherapy and 6 months after cessation of chemotherapy. During the treatment,the time and paclitaxel dose of peripheral nerve toxic reaction occurred were observed in the 2 groups. Pre and post chemotherapy,the sensory nerve conduction velocity( SNCV) and motor nerve conduction velocity( MNCV) of peroneal nerve and the median nerve were detected in the 2 groups. Results 3 cycles after treatment,6 cycles after treatment,2 months after cessation of chemotherapy and 6 months after cessation of chemotherapy,the rates of peripheral nerve toxic reaction were significantly lower in observation group than which in the control group( P < 0. 05). During the treatment,the peripheral nerve toxic reaction occurred time and paclitaxel dose were significantly higher in observation group than which in the control group( P < 0. 05). Post chemotherapy,the SNCV and MNCV of peroneal nerve and the median nerve were significantly higher in observation group than which in the control group( P < 0. 05). Conclusion Vitamin B1 and mecobalamine could prevent paclitaxel chemotherapy induced peripheral nerve toxic reaction in patients with lung cancer,it is worthy of further study.
Objective To observe the effects of vitamin B1 and mecobalamine in preventing paclitaxel chemotherapy induced peripheral nerve toxic reaction in patients with lung cancer. Methods 72 lung cancer patients were randomly divided into the observation group and the control group,36 cases in each group. The 2 groups were treated by TP regiment( paclitaxel plus cisplatin),and vitamin B1 and mecobalamine were additionally given in the observation group. The peripheral neurotoxicity of the2 groups was evaluated 3 cycles after treatment,6 cycles after treatment,2 months after cessation of chemotherapy and 6 months after cessation of chemotherapy. During the treatment,the time and paclitaxel dose of peripheral nerve toxic reaction occurred were observed in the 2 groups. Pre and post chemotherapy,the sensory nerve conduction velocity( SNCV) and motor nerve conduction velocity( MNCV) of peroneal nerve and the median nerve were detected in the 2 groups. Results 3 cycles after treatment,6 cycles after treatment,2 months after cessation of chemotherapy and 6 months after cessation of chemotherapy,the rates of peripheral nerve toxic reaction were significantly lower in observation group than which in the control group( P < 0. 05). During the treatment,the peripheral nerve toxic reaction occurred time and paclitaxel dose were significantly higher in observation group than which in the control group( P < 0. 05). Post chemotherapy,the SNCV and MNCV of peroneal nerve and the median nerve were significantly higher in observation group than which in the control group( P < 0. 05). Conclusion Vitamin B1 and mecobalamine could prevent paclitaxel chemotherapy induced peripheral nerve toxic reaction in patients with lung cancer,it is worthy of further study.
引文
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[10]熊绍权,邹晓玲,郑巧,等.参附注射液对紫杉醇外周神经毒性的影响[J].四川大学学报(医学版),2018,49(1):44-47.
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[14]季文.甲钴胺联合α-硫辛酸治疗糖尿病周围神经病变疗效的观察[J].中国药物与临床,2016,16(9):1343-1345.
[15]乔奇,赵志刚.维生素B1及其衍生物对糖尿病神经病变的影响[J].中国糖尿病杂志,2016,8(4):244-246.
[2]姚忠强,柳仲秋,赵志友,等.125I粒子植入联合DP方案治疗中晚期肺鳞癌的临床疗效[J].实用癌症杂志,2017,32(12):1970-1973.
[3]张洪琼.吉西他滨联合顺铂方案与多西他赛联合奈达铂方案对晚期肺鳞癌的疗效比较[J].实用癌症杂志,2017,32(7):1156-1158.
[4]赵冰清,焦园园,史蕤,等.非小细胞肺癌患者紫杉醇3周方案给药后关键药代动力学参数Tc>0.05与临床毒性相关性研究[J].临床药物治疗杂志,2016,14(4):50-53.
[5]中国抗癌协会肺癌专业委员会.2010中国肺癌临床指南[M].北京:人民卫生出版社,2010:31.
[6]万崇华,陈明清,张灿珍,等.癌症患者生命质量测定量表EORTC QLQ-C30中文版评介[J].实用肿瘤杂志,2005,20(4):353-355.
[7]马悦,赖欢,梁慧,等.普鲁兰多糖接枝聚乳酸紫杉醇大分子胶束的制备及体内初步毒性评价[J].沈阳药科大学学报,2017,34(4):275-284.
[8]陆娟.甲钴胺在乳腺癌多西紫杉醇化疗所致外周神经毒性中的防治效果分析[J].中国实用医药,2016,11(27):204-205.
[9]张清.紫杉醇注射液不良反应的预防及处理[J].临床合理用药杂志,2017,10(1):5-6.
[10]熊绍权,邹晓玲,郑巧,等.参附注射液对紫杉醇外周神经毒性的影响[J].四川大学学报(医学版),2018,49(1):44-47.
[11]陈凯.左卡尼汀预防紫杉醇周围神经毒性的临床观察[J].中国伤残医学,2016,24(3):199-200.
[12]周艳.抗肿瘤药紫杉醇的不良反应及临床合理用药分析[J].中国现代药物应用,2017,11(9):138-139.
[13]陈永华.浅析甲钴胺在临床各科的应用及研究进展[J].中国医药指南,2013,11(24):254-255.
[14]季文.甲钴胺联合α-硫辛酸治疗糖尿病周围神经病变疗效的观察[J].中国药物与临床,2016,16(9):1343-1345.
[15]乔奇,赵志刚.维生素B1及其衍生物对糖尿病神经病变的影响[J].中国糖尿病杂志,2016,8(4):244-246.