Zhongshan Hospital, Fudan University, Shanghai, China.
J Investig Med High Impact Case Rep. 2024 Jan-Dec;12:23247096241281603. doi: 10.1177/23247096241281603.
Paclitaxel plus carboplatin is the most common regimen for the treatment of ovarian cancer. While generally effective, these chemotherapy agents can cause adverse events such as myelotoxicity, nausea, vomiting, and rarely, hepatotoxicity. Paclitaxel is associated with mild elevations in serum aminotransferase levels, but significant hepatotoxicity is uncommon, particularly in patients without prior liver disease. We present a patient with ovarian cancer who developed significant elevation of serum aminotransferases up to 12 times the upper limit of normal after the first cycle of paclitaxel plus carboplatin chemotherapy. Extensive evaluations excluded other potential causes of liver injury and the diagnosis of paclitaxel-induced liver injury was confirmed. The patient was treated with liver protective medications and a reduced dose of paclitaxel (135 mg/m) for subsequent cycles. Her liver function tests stabilized within 2 to 3 times the upper limit of normal, allowing continuation of chemotherapy and achieving a favorable outcome.
紫杉醇联合卡铂是治疗卵巢癌最常用的方案。虽然这些化疗药物通常有效,但它们可能会引起不良反应,如骨髓抑制、恶心、呕吐,极少数情况下还会引起肝毒性。紫杉醇可引起血清氨基转移酶水平轻度升高,但严重肝毒性并不常见,尤其是在无既往肝病的患者中。我们报告了 1 例卵巢癌患者,在紫杉醇联合卡铂化疗第 1 周期后,血清氨基转移酶升高至正常值上限的 12 倍以上。广泛的评估排除了其他潜在的肝损伤原因,并确诊为紫杉醇引起的肝损伤。患者接受了保肝药物治疗,并在下一个周期减少了紫杉醇(135mg/m)的剂量。她的肝功能检查在正常值上限的 2 到 3 倍内稳定下来,允许继续化疗并取得了良好的结果。