神经节苷脂预防奥沙利铂致末梢神经毒性30例临床研究

Clinical Study on Gangliosides for Preventing Oxaliplatin Induced Peripheral Neurotoxicity in 30 Cases

目的观察神经节苷脂预防奥沙利铂致末梢神经毒性的疗效。方法将接受FOLFOX6方案的患者随机分为3组,即神经节苷脂组、钙镁合剂组及单纯化疗组。利用奥沙利铂专用神经毒性分级标准观察其神经毒性发生率及严重程度。结果神经节苷脂组、钙镁合剂组及单纯化疗组急性神经毒性发生率分别为64.28%,66.67%,92.59%,差异有统计学意义（P〈0.05）。化疗4周期和8周期时3组慢性神经毒性发生率差异有统计学意义（P〈0.05）;神经节苷脂组和钙镁合剂组Ⅰ-Ⅲ度神经毒性均低于单纯化疗组（P〉0.05）,神经节苷脂组和钙镁合剂组差异无统计学意义（P〉0.05）。结论应用神经节苷脂可有效预防或减少奥沙利铂神经毒性的发生率及损害程度。

Objective To observe the effects of gangliosides for preventing the oxaliplatin induced peripheral neurotoxicity. Methods 85 patients with colorectal cancer treated by oxaliplatin ＋ fluorouracil ＋ calcium folinate chemotherapeutical regimen（ FOLFOX） were randomly divided into the three groups of gangliosides,calcium and magnesium（ Ca / Mg） mixture and simple chemotherapy. According to the specific nerve toxicity grading standard of oxaliplatin, the neurotoxicity incidence and severity of all patients were observed. Results The neurotoxicity incidences of the gangliosides group,the Ca / Mg mixture group and the simple chemotherapy group were 64. 28%,66. 67%and 92. 59% respectively, the differences among them were statistically significant（ P〈0. 05）. There were statistically significant differences in chronic neurotoxicity after 4 and 8 cycles of chemotherapy among the three groups（ P〈0. 05）. The grade I- Ⅲ neurotoxicity in the Ca / Mg mixture group and the gangliosides group were lower than that in the simple chemotherapy group（ P〉0. 05）,but the difference between the Ca / Mg mixture group and the gangliosides group had no statistical significance. Conclusion Using gangliosides can prevent the neurotoxicity occurrence effectively,and can decrease the incidence and the lesion degree of oxaliplatin induced neurotoxicity.