Verstappen C C P, Postma T J, Hoekman K, Heimans J J
Department of Neurology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
J Neurooncol. 2003 Jun;63(2):201-5. doi: 10.1023/a:1023952106955.
To evaluate the peripheral neuropathic changes induced by combination chemotherapy including paclitaxel (taxol), gemcitabine and cisplatin (TGC regimen).
Eighteen patients with primary or recurrent ovarian cancer were treated with paclitaxel 150 or 110 mg/m2, respectively, together with gemcitabine 800 mg/m2 and cisplatin 75 mg/m2, 3 weekly for 6 cycles. Neurologic evaluation and quantitative assessment by vibration perception threshold (VPT) and grip strength took place before therapy, after 3 and 6 cycles of chemotherapy, and thereafter when possible.
Both neuropathic symptoms and signs developed in all patients (100%), becoming most prominent 3 months after the last course of chemotherapy. Grade 3 peripheral neuropathy developed in one patient during chemotherapy, and in 3 additional patients after cessation of therapy. No significant differences were observed between chemo-naive patients and pretreated patients.
This TGC combination is well tolerated in terms of peripheral neuropathy during therapy, although the off-therapy worsening caused by cisplatin remains a problem.
评估包括紫杉醇（泰素）、吉西他滨和顺铂（TGC方案）的联合化疗所引起的周围神经病变改变。
18例原发性或复发性卵巢癌患者分别接受150mg/m²或110mg/m²的紫杉醇治疗，同时联合800mg/m²吉西他滨和75mg/m²顺铂，每3周1次，共6个周期。在治疗前、化疗3个周期和6个周期后以及之后尽可能进行神经学评估，并通过振动觉阈值（VPT）和握力进行定量评估。
所有患者（100%）均出现神经病变症状和体征，在最后一个疗程化疗后3个月最为明显。1例患者在化疗期间出现3级周围神经病变，另外3例患者在治疗停止后出现。初治患者和预处理患者之间未观察到显著差异。
就治疗期间的周围神经病变而言，这种TGC联合方案耐受性良好，尽管顺铂导致的治疗后病情恶化仍然是一个问题。
