Christodoulou C, Anastasopoulos D, Visvikis A, Mellou S, Detsi I, Tsiakalos G, Pateli A, Klouvas G, Papadimitriou A, Skarlos D V
Second Oncology Department; Neurology Department, Henry Dunant Hospital, Athens, Greece.
Anticancer Drugs. 2004 Nov;15(10):997-9. doi: 10.1097/00001813-200411000-00010.
We report Guillain-Barre syndrome (GBS), developed in a patient with metastatic colon cancer, receiving oxaliplatin-based chemotherapy. The 53-year-old patient was treated with first-line chemotherapy consisting of oxaliplatin 45 mg/m2, 5-fluorouracil 450 mg/m2 and folinic acid 200 mg/m2, all given on the same day in a weekly schedule. After 13 weeks of treatment and a cumulative oxaliplatin dose of 585 mg/m2, the patient developed unsteadiness of gait, dysphagia, and weakness of both the upper and lower limbs, as well as impairment of all sensory modalities. Clinical examination, computed tomography and magnetic resonance imaging scans of the brain, blood tests, nerve conduction studies, and cerebrospinal fluid analysis confirmed the diagnosis of GBS. Intravenous immunoglobulin G was administered for 5 days and the patient recovered fully. Oxaliplatin can cause acute and delayed neurotoxicity, but this is the first report of GBS in a patient receiving oxaliplatin-based chemotherapy. Elevation of pro-inflammatory cytokines, such as tumor necrosis factor-alpha and interleukin-6, induced by oxaliplatin, may represent the relevant causal links involved in the cascade of events which have led to the immune-mediated demyelination in the peripheral nervous system in this patient.
我们报告了1例转移性结肠癌患者在接受基于奥沙利铂的化疗后发生吉兰-巴雷综合征（GBS）。该53岁患者接受一线化疗，方案为奥沙利铂45 mg/m²、5-氟尿嘧啶450 mg/m²和亚叶酸200 mg/m²，均于同一天给药，每周1次。治疗13周且奥沙利铂累积剂量达585 mg/m²后，患者出现步态不稳、吞咽困难、双上肢和双下肢无力以及所有感觉模态受损。临床检查、脑部计算机断层扫描和磁共振成像扫描、血液检查、神经传导研究以及脑脊液分析均确诊为GBS。给予静脉注射免疫球蛋白G治疗5天，患者完全康复。奥沙利铂可引起急性和迟发性神经毒性，但这是首例接受基于奥沙利铂化疗的患者发生GBS的报告。奥沙利铂诱导的促炎细胞因子如肿瘤坏死因子-α和白细胞介素-6升高，可能代表了导致该患者外周神经系统免疫介导脱髓鞘的一系列事件中的相关因果联系。
