University of Strathclyde, Glasgow, G4 0NT, UK.
Dalton Trans. 2018 May 15;47(19):6645-6653. doi: 10.1039/c8dt00838h.
The platinum-based drugs cisplatin, carboplatin and oxaliplatin are regularly prescribed in the treatment of cancer and while they are effective, their use is limited by their severe, dose-limiting side effects (also referred to as adverse effects/events). In total, a cancer patient can experience any combination of around 40 specific side effects. The dose-limiting side effect for cisplatin is nephrotoxicity, for carboplatin it is myelosuppression, and for oxaliplatin it is neurotoxicity. Other common side effects include anaphylaxis, cytopenias (including leukopenia and neutropenia, thrombocytopenia, and anaemia), hepatotoxicity, ototoxicity, cardiotoxicity, nausea and vomiting, diarrhea, mucositis, stomatitis, pain, alopecia, anorexia, cachexia, and asthenia. The side effects may require patients to be prescribed dose reductions in their platinum drugs of between 25 and 100%. Furthermore, patients require extensive monitoring of their biochemistries, kidney and liver function, and depending on the drug, hearing tests. Finally, patients are commonly co-prescribed additional non-chemotherapy based drugs to treat the side effects which can include antiemetics, antibiotics and myeloid growth factors, mannitol, propafenone, saline hyperhydration, magnesium supplements, monoclonal antibody cytokine blockers, and antioxidants.
顺铂、卡铂和奥沙利铂等铂类药物常被用于癌症治疗，虽然它们具有疗效，但由于其严重的、剂量限制的副作用（也称为不良反应/事件），其应用受到限制。总的来说，癌症患者可能会经历大约 40 种特定副作用的任意组合。顺铂的剂量限制副作用是肾毒性，卡铂的是骨髓抑制，奥沙利铂的是神经毒性。其他常见的副作用包括过敏反应、血细胞减少症（包括白细胞减少症和中性粒细胞减少症、血小板减少症和贫血）、肝毒性、耳毒性、心脏毒性、恶心和呕吐、腹泻、黏膜炎、口腔炎、疼痛、脱发、食欲不振、恶病质和乏力。副作用可能需要患者减少铂类药物的剂量，减少幅度在 25%到 100%之间。此外，患者需要对其生化、肾功能和肝功能进行广泛监测，并且根据药物的不同，还需要进行听力测试。最后，患者通常还需要同时使用其他非化疗药物来治疗副作用，这些药物包括止吐药、抗生素和骨髓生长因子、甘露醇、普罗帕酮、盐水水化、镁补充剂、单克隆抗体细胞因子阻滞剂和抗氧化剂。
