氨磷汀对消化道肿瘤化疗患者周围神经毒性的预防效果分析

Analysis on the preventive effect of amifostine on peripheral neurotoxicity in patients with gastrointestinal cancer undergoing chemotherapy

目的研究氨磷汀对消化道肿瘤化疗患者周围神经毒性的预防效果。方法选取中山大学附属第八医院2015年6月至2018年2月收治的接受mFOLFOX6方案化疗的肿瘤患者80例作为研究对象。将其按照随机数字表法均分成研究组和对照组。对照组予以mFOLFOX6方案化疗,研究组则在使用mFOLFOX6方案化疗前予以氨磷汀静脉滴注。分别比较两组周围神经毒性发生情况,化疗前、后正中神经、腓神经的运动神经传导速度(motor nerve conduction velocity,MSV)、感觉神经传导速度(sensory nerve conduction velocity,SCV)水平,近期疗效以及血液毒性发生情况。结果研究组周围神经毒性总发生率为17.50%(7/40),对照组为82.50%(33/40),两组比较差异有统计学意义(χ^2值为33.800,P值为0.000)。化疗后研究组正中神经、腓神经的SCV水平分别为(53.68±3.02)、(54.96±3.01) m/s,对照组分别为(45.17±3.07)、(44.97±3.03) m/s,两组比较差异均有统计学意义(t值分别为12.498、14.794,P值均为0.000)。研究组治疗总有效率为87.50%(35/40),对照组为90.00%(36/40),两组比较差异无统计学意义(χ^2=0.125;P=0.723)。研究组血液毒性总发生率为42.50%(17/40),对照组为77.50%(31/40),两组比较差异有统计学意义(χ^2值为10.208,P=0.001)。结论氨磷汀对肿瘤化疗患者周围神经毒性的预防效果较好,能降低血液毒性反应发生,值得临床推广应用。

Objective To study the protective effect of aminophosphate on peripheral neurotoxicity in patients with gastrointestinal cancer undergoing chemotherapy. Methods Eighty patients receiving mFOLFOX6 regimen chemotherapy in the Eighth Affiliated Hospital of Sun Yat-sen University from June 2015 to February 2018 were selected as the study subjects.They were divided into study group and control group according to random number table method.The control group was given mFOLFOX6 regimen for chemotherapy, while the study group was given intravenous infusion of amphostatin before using mFOLFOX6 regimen for chemotherapy.The occurrence of peripheral neurotoxicity, motor nerve conduction velocity (MSV), sensory nerve conduction velocity (SCV) levels of median nerve and peroneal nerve before and after chemotherapy, short-term efficacy and blood toxicity were compared between the two groups. Results The total incidence of peripheral neurotoxicity was 17.50%(7/40) in the study group and 82.50%(33/40) in the control group, and the difference was statistically significant(χ^2=33.800;P=0.000). The SCV levels of median nerve and peroneal nerve in the study group after chemotherapy was (53.68±3.02) m/s,(54.96±3.01) m/s, and those in the control group were(45.17±3.07) m/s、(44.97±3.03) m/s, and the difference was statistically significant(t=12.498, 14.794;P=0.000, 0.000). There was no significant difference in the total effective rate (87.50%, 35/40) between the study group and the control group (90.00%, 36/40)(χ^2=0.125;P=0.723). The total incidence of hematotoxicity was 42.50%(17/40) in the study group and 77.50%(31/40) in the control group, and the difference was statistically significant(χ^2=10.208;P=0.000). Conclusion Amfostine has a better preventive effect on peripheral neurotoxicity in cancer patients undergoing chemotherapy, which is conducive to reducing the risk of hematotoxicity.which is worthy of clinical application.