Uña Esther
Medical Oncology Service, Clinical University Hospital, Valladolid, Spain.
J Oncol Pharm Pract. 2010 Dec;16(4):280-2. doi: 10.1177/1078155209355849. Epub 2009 Dec 16.
Neurotoxicity is the main and dose-limiting toxicity of oxaliplatin. It may produce two different syndromes, acute and chronic. We describe here a case of a patient with an acute syndrome with the particularity of affecting only contralateral hemibody to arm of infusion. A 62-year-old female diagnosed with stage IV colon cancer, underwent palliative treatment with combination of oxaliplatin (130 mg/m( 2) on day 1), capecitabine (1.250 mg/m(2) bid on days 1 to 14 every 3 weeks), and bevacizumab. Thirty minutes after cycle 1 oxaliplatin infusion, which was into the left arm, she experienced right hemibody paresthesia with muscle cramping of her right calf. She associated dysphonia and painful jamming sensation in her right upper limb with difficulty to release grip. She noted also undulating movements under the skin of her right lower extremity. She was unable to stand or walk. She was given intravenous magnesium sulfate and calcium gluconate and after 3 h all her symptoms were solved. Subsequent doses were reduced by 25% and the infusions were prolonged to 3 h and the patient tolerated well except minimal paresthesia in her right hand lasting few minutes.
神经毒性是奥沙利铂的主要剂量限制性毒性。它可能产生两种不同的综合征，即急性和慢性综合征。我们在此描述一例患有急性综合征的患者，其特殊之处在于仅影响输液侧手臂对侧的半侧身体。一名62岁女性被诊断为IV期结肠癌，接受了奥沙利铂（第1天130mg/m²）、卡培他滨（每3周第1至14天1.250mg/m²，每日两次）和贝伐单抗联合的姑息治疗。在第1周期奥沙利铂经左臂输注30分钟后，她出现了右半侧身体感觉异常，右小腿肌肉痉挛。她还伴有发音困难以及右上肢疼痛性卡压感，难以松开握力。她还注意到右下肢皮肤下有波动感。她无法站立或行走。给予她静脉注射硫酸镁和葡萄糖酸钙，3小时后所有症状均得到缓解。后续剂量减少25%，输注时间延长至3小时，除右手有持续几分钟的轻微感觉异常外，患者耐受良好。
