Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu Province, China.
Biomed Pharmacother. 2012 Jun;66(4):279-84. doi: 10.1016/j.biopha.2012.01.002. Epub 2012 Feb 17.
Oxaliplatin is a key agent in the treatment of colorectal cancer. However, peripheral neuropathy markedly limits the use of oxaliplatin. This retrospective study was performed to assess the efficacy of monosialotetrahexosylganglioside (GM1) for preventing oxaliplatin induced neurotoxicity. Patients with colorectal cancer treated with oxaliplatin based chemotherapy (FOLFOX or XELOX) were retrospectively divided into two groups according to the use of GM1. The severity of neurotoxicity and efficacy of oxaliplatin were evaluated. A total of 278 cases were included, 114 in GM1 group and 164 in control group. A significantly lower incidence of grade 1-3 acute neurotoxicity (81% vs 92%, p=0.006), grade 2 acute neurotoxicity (26% vs 45%, p=0.002) was observed in GM1 group. Similarly, incidence of grade 1-3 (30% vs 48%, p=0.003) and grade 3 chronic neurotoxicity (4% vs 13%, p=0.021) was also lower in GM1 group. No difference was detected in objective response rate, progress free survival, and median overall survival between GM1 group and control group. The retrospective study demonstrated that GM1 significantly reduced the incidence of oxaliplatin induced neuropathy, especially severe neuropathy, without impairment of efficacy. Prospective trials of GM1 as neuroprotective of oxaliplatin treatment in colorectal cancer are warranted.
奥沙利铂是治疗结直肠癌的关键药物。然而，周围神经病变显著限制了奥沙利铂的使用。本回顾性研究旨在评估单唾液酸四己糖神经节苷脂（GM1）预防奥沙利铂诱导的神经毒性的疗效。根据 GM1 的使用情况，将接受奥沙利铂为基础的化疗（FOLFOX 或 XELOX）的结直肠癌患者回顾性地分为两组。评估神经毒性的严重程度和奥沙利铂的疗效。共纳入 278 例患者，GM1 组 114 例，对照组 164 例。GM1 组急性神经毒性 1-3 级（81%比 92%，p=0.006）和 2 级（26%比 45%，p=0.002）的发生率显著降低。同样，GM1 组 1-3 级（30%比 48%，p=0.003）和 3 级慢性神经毒性（4%比 13%，p=0.021）的发生率也较低。GM1 组和对照组之间的客观缓解率、无进展生存期和中位总生存期无差异。这项回顾性研究表明，GM1 显著降低了奥沙利铂引起的神经病变的发生率，特别是严重的神经病变，而不影响疗效。需要进行前瞻性试验，以评估 GM1 作为奥沙利铂治疗结直肠癌的神经保护剂的效果。
