Ahmed T, Engelking C, Szalyga J, Helson L, Coombe N, Cook P, Corbi D, Puccio C, Chun H, Mittelman A
Department of Medicine, New York Medical College, Valhalla 10595.
Bone Marrow Transplant. 1993 Aug;12(2):131-2.
Mucosal toxicity is dose limiting for etoposide. This may be related to the direct effects of etoposide on the mucosa. Twelve patients receiving etoposide 1800 mg/m2 as part of a myeloablative pre-transplant regimen were randomized to receive propantheline 30 mg or placebo orally every 6 h for six doses. Mucositis was less frequent (2 of 6 vs 5 of 6) and less severe (p = 0.05) in the propantheline arm. There were no differences in tumor response or survival between the two groups. Propantheline is an anticholinergic that causes xerostomia by decreasing salivation. Propantheline may reduce the salivary excretion of etoposide and could reduce its toxic effects on the mucosa. Propantheline is effective in reducing the incidence and severity of mucositis in patients receiving high-dose etoposide.
黏膜毒性是依托泊苷的剂量限制性毒性。这可能与依托泊苷对黏膜的直接作用有关。12例接受1800mg/m²依托泊苷作为清髓性移植前方案一部分的患者被随机分为两组，分别每6小时口服30mg丙胺太林或安慰剂，共六剂。丙胺太林组的黏膜炎发生率较低（6例中的2例 vs 6例中的5例）且严重程度较轻（p = 0.05）。两组之间的肿瘤反应或生存率无差异。丙胺太林是一种抗胆碱能药物，通过减少唾液分泌导致口干。丙胺太林可能会减少依托泊苷的唾液排泄，并可能降低其对黏膜的毒性作用。丙胺太林可有效降低接受高剂量依托泊苷患者的黏膜炎发生率和严重程度。
