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顺铂所致脑病的管理:一例报告及文献综述

Management of Cisplatin-Induced Encephalopathy: A Case Report and Literature Review.

作者信息

Jebrouni Fadoua, Bailal Hanan, Omari Mouhsine, Khater Kaouthar, Bali Asmae, Al Jarroudi Ouissam, Brahmi Sami Aziz, Afqir Said

机构信息

Medical Oncology, Mohammed I University, Oujda, MAR.

Medical Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR.

出版信息

Cureus. 2024 Jun 11;16(6):e62176. doi: 10.7759/cureus.62176. eCollection 2024 Jun.

Abstract

Cisplatin is a cancer therapy drug commonly used. It is well-known for its antineoplastic properties, as well as for its numerous adverse effects, particularly its neurotoxicity. Symptoms associated with a central nervous system injury are unusual but can present a diagnostic challenge. Here, we report a case of a 62-year-old patient who was diagnosed with undifferentiated nasopharyngeal carcinoma. Cisplatin-based chemotherapy was administrated. Five days following the second cycle of treatment, the patient presented neurological disorders. A full biological workup and brain imaging were requested and revealed no abnormalities. The diagnosis of cisplatin encephalopathy was then suspected. Twenty days after cessation of cisplatin therapy, the neurological symptoms began to improve. Based on our case and a review of the literature, cisplatin-induced encephalopathy remains unusual. Its diagnosis is based on a combination of clinical, biological, and radiological criteria and requires the exclusion of other etiologies for neurological disorders in a patient being treated for cancer. Treatment is symptomatic and depends on stopping cisplatin therapy. These neurological adverse effects are often transitory and disappear without major repercussions.

摘要

顺铂是一种常用的癌症治疗药物。它以其抗肿瘤特性以及众多不良反应而闻名,尤其是其神经毒性。与中枢神经系统损伤相关的症状并不常见,但可能带来诊断挑战。在此,我们报告一例62岁患者,该患者被诊断为未分化鼻咽癌。给予了基于顺铂的化疗。在第二个治疗周期后的第五天,患者出现神经功能障碍。进行了全面的生物学检查和脑部成像,未发现异常。随后怀疑为顺铂脑病。在停止顺铂治疗20天后,神经症状开始改善。基于我们的病例以及文献回顾,顺铂诱导的脑病仍然不常见。其诊断基于临床、生物学和放射学标准的综合判断,并且需要排除正在接受癌症治疗患者中其他导致神经功能障碍的病因。治疗以对症治疗为主,取决于停止顺铂治疗。这些神经不良反应通常是暂时的,且消失后无重大影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/130c/11239081/518a063261a6/cureus-0016-00000062176-i01.jpg

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