Fu K K, Kai E F, Leung C K
Department of Medicine, University of Hong Kong, Queen Mary Hospital.
J Clin Pharm Ther. 1995 Jun;20(3):167-72. doi: 10.1111/j.1365-2710.1995.tb00644.x.
Nineteen Chinese patients with stage III or IV epithelial ovarian carcinoma by the criteria established by the International Federation of Gynaecology and Obstetrics, treated with cisplatin, 120 mg/m2, every 4 weeks for a maximum of twelve courses if possible, were studied prospectively with clinical and electrophysiological evaluation before and 3, 6, 9 and 12 months during cisplatin administration. Neuropathy occurred in 12 of the 19 patients at the cumulative dose of 360 mg/m2. Up to 89% of the patients assessed in their final examination developed neuropathy. Decreased vibration sensation at the ankles and depressed ankle reflexes were the early manifestations. Electrophysiological findings consisted of low amplitude sensory action potentials of median, ulnar and sural nerves, and slowing of their sensory nerve conduction velocities. Despite substantial involvement of sensory nerves, there was little change in motor nerve conduction velocities or motor unit action potentials. The progression of the neuropathy was unpredictable and could be delayed. As cisplatin is highly effective in the treatment of the tumour which is invariably fatal, if inadequately treated, patient selection with regard to neurotoxicity is unnecessary.
按照国际妇产科联盟制定的标准,19例III期或IV期上皮性卵巢癌中国患者接受了顺铂治疗,剂量为120mg/m²,每4周一次,若可能,最多进行12个疗程。在顺铂给药前以及给药期间的3、6、9和12个月,对患者进行了临床和电生理评估的前瞻性研究。19例患者中有12例在累积剂量达360mg/m²时出现神经病变。在最后一次检查中,高达89%的患者出现了神经病变。踝关节振动觉减退和踝反射减弱是早期表现。电生理检查结果包括正中神经、尺神经和腓肠神经的感觉动作电位幅度降低,以及感觉神经传导速度减慢。尽管感觉神经受累严重,但运动神经传导速度或运动单位动作电位变化不大。神经病变的进展不可预测且可能延迟。由于顺铂在治疗这种若治疗不当必然致命的肿瘤方面非常有效,因此无需针对神经毒性进行患者选择。