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多西他赛所致化疗性脱发:发生率、治疗及预防。

Chemotherapy-Induced Alopecia by Docetaxel: Prevalence, Treatment and Prevention.

机构信息

Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.

Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA.

出版信息

Curr Oncol. 2024 Sep 23;31(9):5709-5721. doi: 10.3390/curroncol31090423.

Abstract

Docetaxel is a commonly used taxane chemotherapeutic agent in the treatment of a variety of cancers, including breast cancer, ovarian cancer, prostate cancer, non-small cell lung cancer, gastric cancer, and head and neck cancer. Docetaxel exerts its anti-cancer effects through inhibition of the cell cycle and induction of proapoptotic activity. However, docetaxel also impacts rapidly proliferating normal cells in the scalp hair follicles (HFs), rendering the HFs vulnerable to docetaxel-induced cell death and leading to chemotherapy-induced alopecia (CIA). In severe cases, docetaxel causes persistent or permanent CIA (pCIA) when hair does not grow back completely six months after chemotherapy cessation. Hair loss has severe negative impacts on patients' quality of life and may even compromise their compliance with treatment. This review discusses the notable prevalence of docetaxel-induced CIA and pCIA, as well as their prevention and management. At this moment, scalp cooling is the standard of care to prevent CIA. Treatment options to promote hair regrowth include but are not limited to minoxidil, photobiomodulation (PBMT), and platelet-rich plasma (PRP). In addition, a handful of current clinical trials are exploring additional agents to treat or prevent CIA. Research models of CIA, particularly human scalp HF organ culture and mouse models with human scalp xenografts, will help expedite the translation of bench findings of CIA prevention and/or amelioration to the clinic.

摘要

多西他赛是一种常用于治疗多种癌症的紫杉烷类化疗药物,包括乳腺癌、卵巢癌、前列腺癌、非小细胞肺癌、胃癌和头颈部癌症。多西他赛通过抑制细胞周期和诱导促凋亡活性发挥抗癌作用。然而,多西他赛也会影响头皮毛囊(HFs)中快速增殖的正常细胞,使 HFs 容易受到多西他赛诱导的细胞死亡的影响,并导致化疗引起的脱发(CIA)。在严重的情况下,当化疗停止后六个月头发完全没有长回来时,多西他赛会导致持续或永久性 CIA(pCIA)。脱发对患者的生活质量有严重的负面影响,甚至可能影响他们对治疗的依从性。本综述讨论了多西他赛引起的 CIA 和 pCIA 的显著流行率,以及它们的预防和管理。目前,头皮冷却是预防 CIA 的标准护理。促进头发生长的治疗选择包括但不限于米诺地尔、光生物调节(PBMT)和富血小板血浆(PRP)。此外,目前有一些临床试验正在探索其他治疗或预防 CIA 的药物。CIA 的研究模型,特别是人类头皮 HF 器官培养和带有人类头皮异种移植物的小鼠模型,将有助于加速将 CIA 预防和/或改善的实验室研究结果转化为临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb52/11431623/15e8a578dfd7/curroncol-31-00423-g001.jpg

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