Markman Maurie
Department of Hematology/Medical Oncology (R35), The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Expert Opin Drug Saf. 2003 Mar;2(2):141-6. doi: 10.1517/14740338.2.2.141.
The taxanes (paclitaxel and docetaxel) are highly active cytotoxic antineoplastic agents. Common toxicities of the drugs include total alopecia, hypersensitivity reactions, bone marrow suppression (principally neutropenia), arthralgia, myalgias, and peripheral neuropathy. When administered as a 3-h infusion, paclitaxel appears to be associated with a lower risk of neutropenia and a greater risk of peripheral neuropathy, compared to either 24-h infusion paclitaxel or docetaxel (1-h infusion). Neither paclitaxel nor docetaxel is associated with a high risk for significant emesis. High cumulative doses of docetaxel have been shown to produce fluid retention (e.g., oedema, ascites, pleural effusions), while paclitaxel, when combined with doxorubicin, increases the risk of anthracycline-induced heart failure. Both paclitaxel and docetaxel have been administered at lower dose levels, on a weekly schedule, with acceptable toxicity profiles. In general, the side effects of the taxanes are manageable, and few patients discontinue treatment due to excessive toxicity.
紫杉烷类（紫杉醇和多西他赛）是高效的细胞毒性抗肿瘤药物。这些药物的常见毒性包括完全脱发、过敏反应、骨髓抑制（主要是中性粒细胞减少）、关节痛、肌痛和周围神经病变。与24小时输注紫杉醇或多西他赛（1小时输注）相比，当以3小时输注方式给药时，紫杉醇似乎与较低的中性粒细胞减少风险和较高的周围神经病变风险相关。紫杉醇和多西他赛均与严重呕吐的高风险无关。已证明高累积剂量的多西他赛会导致液体潴留（如水肿、腹水、胸腔积液），而紫杉醇与阿霉素联合使用时，会增加蒽环类药物引起的心力衰竭风险。紫杉醇和多西他赛均已以较低剂量水平按每周给药方案使用，且毒性特征可接受。一般来说，紫杉烷类的副作用是可控的，很少有患者因毒性过大而停止治疗。
