长效核黄素预防大剂量甲氨喋呤化疗毒副反应疗效观察

Prevention of drug adverse effects by use of riboflavin laurate in high-dose methotrexate chemotherapy

目的观察长效核黄素对大剂量甲氨喋吟(HD-MTX)化疗常见毒副反应的预防效果。方法1996年10月至2004年8月期间,26例患儿共接受72个疗程HD-MTX化疗(3.0g/m2,持续静滴12 h),观察组41个疗程同时应用长效核黄素,对照组31个疗程不用。根据WHO抗癌药物毒副反应分度标准,观察比较两组患儿治疗后口腔黏膜损害、肝功能变化及骨髓抑制程度。结果观察组口腔黏膜损害发生率(12.2%,5/41)明显低于对照组(45.2%,14/31),且观察组损害程度较重(P=0.002)。两组间肝功能变化及骨髓抑制程度差异无显著性。结论HD-MTX化疗中应用长效核黄素可有效预防口腔黏膜损害,对肝功能损害及骨髓抑制无明显预防作用。

Objective To observe the preventive efficacy of riboflavin laurate for the drug adverse effects in high -dose methotrexate（ HD -MTX） chemotherapy. Methods 26 children were treated with 72 courses of HD -MTX chemotherapy （3.0g/m^2 for 12 -hour infusion）. Out of the 72 courses, 41 courses constituted the test group, the other 31 ones belonged to the control group. Patients in the test group were injected intramuscularly with riboflavin laurate 1 day before HD -MTX chemotherapy, while patients in the control group were not. After HD -MTX chemotherapy, oral mucositis, liver dysfunction and hemopoiesis repression were observed and evaluated according to the WHO criteria about the adverse effects of anticancer drugs, then compared the aforementioned adverse effects occurred in test group with those in control group. Results The morbidity of oral mucositis was significantly lower among patients of test group than among patients of control group（ 12.2% vs. 45.2%, P =0.002） ,but for liver dysfunction and hemopoiesis repression, there were no significant differences between the two groups. Conclusion These results suggest that riboflavin laurate can prevent oral mucositis in HD -MTX chemotherapy, but for liver dysfunction and hemopoiesis repression, riboflavin laurate has no preventive efficacy.