Qi Guoyan, Xue Yinping, Li Yongzhao, Yang Hongxia, Zhang Xiaojing
No. 9 Fangbei Road, Chang'an District, Shijiangzhuang 050011, Hebei Province, China.
Center of Treatment of Myasthenia Gravis Hebei Province, First Hospital of Shijiazhuang, Shijiazhuang050011, China.
Open Med (Wars). 2017 Dec 2;12:403-408. doi: 10.1515/med-2017-0058. eCollection 2017.
Therapeutic options for thymoma-associated myasthenia gravis (MG) patients complicated with hypertension and/or diabetes post thymectomy are often conventional steroids. As the prevalence of diabetes and hypertension globally increases, other therapeutic options for these patients are of great importance.
MATERIAL/METHODS: 9 patients with thymoma-associated MG complicated with hypertension and/or diabetes after thymectomy were administered 75 mg/m2 of docetaxel and 70 mg/m2 of cisplatin on day 1. The treatment could be repeated at 3-week intervals, ranging from 1 to 4 cycles according to the status of the patients. Therapeutic efficacy and side effects were evaluated.
2 patients were complicated with type 2 diabetes, 6 with hypertension, and 1 with both diabetes and hypertension. After docetaxel/cisplain therapy, the MG symptoms were markedly improved in all patients (2, complete remission; 3, basic remission; 3, marked improvement; 1, improvement). Acetylcholine receptor (AchR) antibody levels were decreased in 8 patients. Minor adverse effects were observed in 2 patients, 1 with Grade II gastrointestinal reaction, and the other with pulmonary infection.
Docetaxel plus cisplatin might be an effective therapeutic option for thymoma-associated MG patients complicated with hypertension /diabetes post thymectomy without worsening thymoma and hypertension / diabetes.
胸腺瘤相关重症肌无力（MG）患者胸腺切除术后合并高血压和/或糖尿病，其治疗选择通常为传统类固醇药物。随着全球糖尿病和高血压患病率的上升，这些患者的其他治疗选择具有重要意义。
材料/方法：9例胸腺切除术后胸腺瘤相关MG合并高血压和/或糖尿病的患者在第1天接受75mg/m²多西他赛和70mg/m²顺铂治疗。治疗可每3周重复一次，根据患者情况进行1至4个周期。评估治疗效果和副作用。
2例患者合并2型糖尿病，6例合并高血压，1例同时合并糖尿病和高血压。多西他赛/顺铂治疗后，所有患者的MG症状均明显改善（2例完全缓解；3例基本缓解；3例显著改善；1例改善）。8例患者的乙酰胆碱受体（AchR）抗体水平降低。2例患者出现轻微不良反应，1例为Ⅱ级胃肠道反应，另1例为肺部感染。
多西他赛加顺铂可能是胸腺切除术后胸腺瘤相关MG合并高血压/糖尿病患者的有效治疗选择，且不会使胸腺瘤及高血压/糖尿病病情恶化。
