维生素B1联合甲钴胺预防肺癌患者紫杉醇化疗所致外周神经毒性的研究

Study on Vitamin B1 and Mecobalamine in Preventing Paclitaxel Chemotherapy Induced Peripheral Nerve Toxic Reaction in Patients with Lung Cancer

目的 观察维生素B1联合甲钴胺对肺癌患者紫杉醇化疗所致外周神经毒性的预防作用。方法 将72例肺癌患者随机分为观察组(36例)和对照组(36例)。对照组患者给予TP方案(紫杉醇+顺铂)进行治疗,观察组在此基础另给予维生素B1联合甲钴胺。在治疗3周期后、治疗6周期后、化疗结束2个月后及化疗结束6个月后,分别对2组患者的外周神经毒性进行评价。化疗期间,密切观察并记录2组患者出现外周神经毒性症状时的紫杉醇使用量及出现外周神经毒性症状的时间。化疗前后,检测2组腓神经与正中神经的运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)。结果 治疗3周期后、治疗6周期后、化疗结束2个月后及化疗结束6个月后,观察组神经毒性发生率均明显低于对照组(P<0.05)。治疗期间,观察组患者出现外周神经毒性的时间晚于对照组(P<0.05),紫杉醇使用量明显大于对照组(P<0.05)。化疗后,观察组腓神经SNCV、腓神经MNCV、正中神经SNCV及正中神经MNCV均明显高于对照组(P<0.05)。结论 化疗的同时给予维生素B1联合甲钴胺能有效预防紫杉醇所致肺癌患者外周神经毒性,值得进行深入研究。

Objective To observe the effects of vitamin B1 and mecobalamine in preventing paclitaxel chemotherapy induced peripheral nerve toxic reaction in patients with lung cancer. Methods 72 lung cancer patients were randomly divided into the observation group and the control group,36 cases in each group.The 2 groups were treated by TP regiment (paclitaxel plus cisplatin),and vitamin B1 and mecobalamine were additionally given in the observation group.The peripheral neurotoxicity of the 2 groups was evaluated 3 cycles after treatment,6 cycles after treatment,2 months after cessation of chemotherapy and 6 months after cessation of chemotherapy.During the treatment,the time and paclitaxel dose of peripheral nerve toxic reaction occurred were observed in the 2 groups.Pre and post chemotherapy,the sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) of peroneal nerve and the median nerve were detected in the 2 groups. Results 3 cycles after treatment,6 cycles after treatment,2 months after cessation of chemotherapy and 6 months after cessation of chemotherapy,the rates of peripheral nerve toxic reaction were significantly lower in observation group than which in the control group ( P <0.05).During the treatment,the peripheral nerve toxic reaction occurred time and paclitaxel dose were significantly higher in observation group than which in the control group ( P <0.05).Post chemotherapy,the SNCV and MNCV of peroneal nerve and the median nerve were significantly higher in observation group than which in the control group ( P <0.05). Conclusion Vitamin B1 and mecobalamine could prevent paclitaxel chemotherapy induced peripheral nerve toxic reaction in patients with lung cancer,it is worthy of further study.