Freilich R J, Balmaceda C, Seidman A D, Rubin M, DeAngelis L M
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Neurology. 1996 Jul;47(1):115-8. doi: 10.1212/wnl.47.1.115.
Paclitaxel and docetaxel are novel chemotherapeutic agents that promote the polymerization and inhibit the depolymerization of microtubules. Sensory neuropathy is common with these agents, particularly paclitaxel. We evaluated 64 patients treated with these drugs; 54 were followed prospectively. Eleven (17%, including six of the 54 prospectively followed patients) developed muscle weakness that was predominantly proximal. The weakness was idiosyncratic, occurring at any stage of treatment, had a variable course, and was reversible upon cessation of drug. All patients developed symptoms or signs of taxane-induced sensory neuropathy. Weakness was likely neuropathic in origin; electrodiagnostic studies suggested a distal axonopathy in some patients and proximal denervation (anterior horn cell or nerve root) in other.
紫杉醇和多西他赛是新型化疗药物，可促进微管聚合并抑制其解聚。感觉神经病变在使用这些药物时很常见，尤其是紫杉醇。我们评估了64例接受这些药物治疗的患者；其中54例进行了前瞻性随访。11例（17%，包括54例前瞻性随访患者中的6例）出现了以近端为主的肌肉无力。这种无力是特异质性的，在治疗的任何阶段都可能发生，病程多变，停药后可逆转。所有患者均出现了紫杉烷诱导的感觉神经病变的症状或体征。无力可能源于神经病变；电诊断研究表明，一些患者存在远端轴索性神经病，另一些患者存在近端失神经（前角细胞或神经根）。
