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紫杉烷类抗癌药物所致神经毒性的治疗与护理

Treatment and care of neurotoxicity from taxane anticancer agents.

作者信息

Makino Haruhiko

机构信息

Department of Surgery, Niigata Prefectural Sakamachi Hospital, 589 Ooaza-Shimokajiya, Arakawamachi, Iwafune-gun, Niigata 959-3193, Japan.

出版信息

Breast Cancer. 2004;11(1):100-4. doi: 10.1007/BF02968011.

Abstract

Taxane anticancer agents play a central role in drug therapy for breast cancer today; however, they have a dose-limiting neurotoxicity that is difficult to prevent and treat. To protect against this neurotoxicity it is important to avoid large doses greater than 200 mg/m2, and to adopt 24-hour administration regimens. Care is also needed with regard to the cumulative dose. Glutamine and amitriptyline are two of the very few drugs that have been found to be clinically effective against drug-induced peripheral neuropathy. Drugs are discontinued if neuropathy appears. If administration is to be later restarted, it is recommended that combined use of glutamine or amitriptyline be considered and that patients be given guidance for daily life.

摘要

紫杉烷类抗癌药物在当今乳腺癌的药物治疗中发挥着核心作用;然而,它们具有剂量限制性神经毒性,难以预防和治疗。为预防这种神经毒性,避免使用大于200mg/m²的大剂量药物并采用24小时给药方案很重要。还需要关注累积剂量。谷氨酰胺和阿米替林是极少数已被发现对药物性周围神经病变临床有效的药物。如果出现神经病变则停用药物。如果后续要重新开始给药,建议考虑联合使用谷氨酰胺或阿米替林,并为患者提供日常生活指导。

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