奥沙利铂治疗胃肠道肿瘤所致神经毒性与累积剂量的相关性分析

Correlation of oxaliplatin cumulative dose with neurotoxicity in patients with gastrointestinal cancer

目的 分析胃肠道肿瘤治疗中奥沙利铂导致的神经毒性反应与累积剂量之间的关系。方法 对79例采用奥沙利铂为主方案治疗的胃肠道肿瘤患者的临床资料进行回顾性分析,记录患者的神经毒性分级、奥沙利铂使用累积剂量及其他化疗不良反应情况。结果 79例患者的神经毒性总体发生率为81.0%,奥沙利铂累积剂量在135-440 mg/m^2时,神经毒性反应的发生率为28.6%;450-820 mg/m^2时,其发生率为61.5%;840-1 000 mg/m^2时,其发生率在100.0%。而4例≥1 200 mg/m^2,2例出现3级神经毒性反应。结论 多数胃肠道肿瘤患者接受含奥沙利铂化疗的方案会出现神经毒性反应,其严重程度与累积剂量呈正相关。

Objective To investigate the correlation of oxaliplatin cumulative dose with neurotoxicity in patients with gastrointestinal cancer. Methods Seventy-nine cases of gastric intestinal cancer receiving oxaliplatin-based chemotherapy were retrospectively analyzed. The correlation of total doses of oxaliplatin with the grade of neurotoxicity and other adverse reaction was analyzed. Results The overall incidence of neurotoxicity was 81.0% and the incidence rates caused by oxaliplatin at cumulative doses of 135 - 440 mg/m^2 ,450 - 820 mg/m^2 and 840 - 1 000 mg/m^2 were 28.6% ,61.5% , 100.0% respectively. Grade 3 neurotoxicity occurred in 2 of 4 patients at a cumulative dose over 1 200 mg/m^2. Conclusion Oxaliplatin-related neurotoxicity was common for patients receiving oxaliplatin-based chemotherapy and the grade of neurotoxicity is correlated with the cumulative dose of oxaliplatin.