Holman Laura L, Ren Yulan, Westin Shannon N
Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Unit 1362, 1155 Herman Pressler, CPB6.3279, Houston, TX, 77030-3721, USA.
Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, 159 Tianzhou Road, Xuhui Area, Shanghai, 200030, China.
BMC Cancer. 2015 Oct 17;15:728. doi: 10.1186/s12885-015-1755-2.
While peripheral neuropathy is a common side effect of platinum-based chemotherapy, central nervous system (CNS) toxicity, such as encephalopathy or seizures, appears to be rare. This manuscript describes the only reported case of nonconvulsive status epilepticus associated with cisplatin in a cervical cancer patient who does not have other underlying medical conditions.
The patient is a 54-year-old Chinese female with recurrent stage IIIB moderately differentiated squamous cell carcinoma of the cervix who was being treated with cisplatin and topotecan. During the sixth cycle of this regimen, the patient presented with mental status changes. While imaging and laboratory values were within normal limits, the patient's EEG revealed nonconvulsive status epilepticus. After appropriate intervention, she made a complete recovery with no further seizures. The patient currently remains on antiepileptic therapy, but is no longer receiving cisplatin.
Patients who present with new onset seizures should primarily be evaluated for underlying medical conditions. Among patients who are suspected to have CNS side effects associated with platinum use, we recommend avoidance of platinum agents in future chemotherapeutic regimens. Although rare, providers should be aware of the potential for CNS toxicity associated with this drug class.
虽然周围神经病变是铂类化疗常见的副作用，但中枢神经系统（CNS）毒性，如脑病或癫痫发作，似乎很少见。本文描述了唯一一例报告的与顺铂相关的非惊厥性癫痫持续状态病例，该病例为一名无其他基础疾病的宫颈癌患者。
患者为一名54岁中国女性，患有复发性IIIB期中度分化宫颈鳞状细胞癌，正在接受顺铂和拓扑替康治疗。在该方案的第六个周期中，患者出现精神状态改变。虽然影像学和实验室检查值在正常范围内，但患者的脑电图显示为非惊厥性癫痫持续状态。经过适当干预，她完全康复，未再发作癫痫。患者目前仍在接受抗癫痫治疗，但不再接受顺铂治疗。
新发癫痫发作的患者应首先评估其基础疾病。在怀疑有与铂类药物使用相关的中枢神经系统副作用的患者中，我们建议在未来的化疗方案中避免使用铂类药物。虽然罕见，但医疗人员应意识到这类药物存在中枢神经系统毒性的可能性。
