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顺铂联合紫杉醇化疗所致周围神经病变的临床及电生理特征

Clinical and electrophysiological features of peripheral neuropathy induced by administration of cisplatin plus paclitaxel-based chemotherapy.

作者信息

Argyriou A A, Polychronopoulos P, Koutras A, Xiros N, Petsas T, Argyriou K, Kalofonos H P, Chroni E

机构信息

Department of Neurology - Laboratory of Clinical Neurophysiology, University of Patras Medical School, Rion-Patras, Greece.

出版信息

Eur J Cancer Care (Engl). 2007 May;16(3):231-7. doi: 10.1111/j.1365-2354.2006.00718.x.

Abstract

The current prospective study sought to trace the incidence and severity of cisplatin plus paclitaxel (DDP+P)-induced neuropathy and to determine its clinical and electrophysiological pattern. Furthermore, it was attempted to describe its evolution by following up the course of peripheral neuropathy (PN) during chemotherapy as well as 3 months after its discontinuation. Thirteen adult patients scheduled to be treated with six courses of cumulative DDP+P-based regimens for a non-myeloid malignancy participated in this study. These patients were clinically and electrophysiologically monitored at baseline, during chemotherapy and 3 months after its discontinuation. The severity of PN was summarized by means of a modified PN score. Evidence of PN was disclosed in nine of the 13 patients (69.2%). The mean PN score for patients that manifested some grade of PN was 17.3 +/- 6.1 (range 9-28). All longitudinal comparisons concerning the motor conduction velocities (MCV) variables failed to reach significance. By contrast, comparisons of the mean changes at baseline and each of the follow-up studies revealed a significant decrease in all sensory action potentials examined. The follow-up evaluation performed 3 months after the discontinuation of chemotherapy showed that the DDP+P-induced neuropathy persists and progresses over time. Our results indicate that the majority of patients treated with a DDP+P-based regimen at full dose intensities would manifest an axonal, predominately sensory PN, of mild to moderate severity, which would persist for several months after the discontinuation of chemotherapy.

摘要

本前瞻性研究旨在追踪顺铂联合紫杉醇(DDP+P)所致神经病变的发生率和严重程度,并确定其临床和电生理模式。此外,还试图通过在化疗期间以及化疗结束后3个月对周围神经病变(PN)病程进行随访,来描述其演变过程。13例计划接受六个疗程基于DDP+P累积方案治疗非髓系恶性肿瘤的成年患者参与了本研究。这些患者在基线、化疗期间以及化疗结束后3个月接受了临床和电生理监测。PN的严重程度通过改良的PN评分进行总结。13例患者中有9例(69.2%)出现了PN证据。出现某种程度PN的患者的平均PN评分为17.3±6.1(范围9-28)。所有关于运动传导速度(MCV)变量的纵向比较均未达到显著差异。相比之下,基线与每次随访研究的平均变化比较显示,所有检测的感觉动作电位均有显著下降。化疗结束后3个月进行的随访评估表明,DDP+P所致神经病变会持续存在并随时间进展。我们的结果表明,大多数接受全剂量强度基于DDP+P方案治疗的患者会出现轻度至中度严重程度的轴索性、以感觉为主的PN,且在化疗结束后会持续数月。

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