Mills K M, Johnson D M, Middlebrooks M, Burton G V
Department of Internal Medicine, LSU Health Sciences Center, Shreveport, Louisiana 71130, USA.
Pharmacotherapy. 2000 Jan;20(1):95-7. doi: 10.1592/phco.20.1.95.34653.
Paclitaxel, a relatively new antineoplastic agent, is associated with numerous side effects, including two reported cases of pancreatitis. Our patient also developed paclitaxel-associated pancreatitis. Several companion drugs, including steroids, diphenhydramine, histamine2 blockers, serotonin type 3 antagonists, and other chemotherapeutic agents administered with paclitaxel, must be considered as possible causes of pancreatitis. In addition, paclitaxel is a hydrophobic agent that requires a vehicle, cremophor (CrEL), for solubility. Intravenous cyclosporine also requires CrEL and has been associated with pancreatitis. In the cerulein-induced pancreatitis rat model, paclitaxel with dimethyl sulfoxide as a vehicle prevents pancreatitis, suggesting that another causal agent is responsible. Animal studies of CrEL as a single agent may be required to settle this question, but for now, awareness that paclitaxel may be associated with pancreatitis may lead to earlier treatment of this potentially fatal complication.
紫杉醇是一种相对较新的抗肿瘤药物，会引发多种副作用，其中包括两例已报告的胰腺炎病例。我们的患者也出现了与紫杉醇相关的胰腺炎。几种辅助药物，包括类固醇、苯海拉明、组胺2受体阻滞剂、5-羟色胺3受体拮抗剂以及与紫杉醇联合使用的其他化疗药物，都必须被视为胰腺炎的可能病因。此外，紫杉醇是一种疏水性药物，需要一种载体聚氧乙烯蓖麻油（CrEL）来助溶。静脉注射环孢素也需要CrEL，并且也与胰腺炎有关。在蛙皮素诱导的胰腺炎大鼠模型中，以二甲基亚砜作为载体的紫杉醇可预防胰腺炎，这表明还有其他致病因素。可能需要对CrEL作为单一药物进行动物研究来解决这个问题，但目前，认识到紫杉醇可能与胰腺炎有关，或许能促使对这种潜在致命并发症进行更早的治疗。
