洛拉替尼片致中枢神经系统毒性1例分析

One case of central nervous system toxicity induced by loratinib tablets

目的探讨洛拉替尼片致中枢神经系统毒性的临床特征及处理措施。方法通过对1例间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)阳性的IV期肺腺癌患者应用洛拉替尼片致中枢神经系统毒性病例分析,结合相关文献,总结本类中枢神经系统毒性临床表现及适宜治疗方式。结果本例患者主要临床表现为对答不切题、睡眠差、情绪激动、易怒、不识人,与国内外报道的洛拉替尼相关性中枢神经毒性相似,立即采取停药措施,给予奥氮平对症处理,3 d后完全缓解,1周后降低洛拉替尼片剂量重启治疗,未再出现中枢神经系统症状。结论洛拉替尼片相关中枢神经系统毒性可严重影响患者生存质量,应引起重视。

Objective To explore the clinical characteristics and disposal of central nervous system toxicity caused by loratinib tablets.Methods One case of central nervous system toxicity caused by loratinib tablets in a stage IV lung adenocarcinoma patient with anaplastic lymphoma kinase(ALK)positivity was analyzed.By retrieving related literature,the clinical manifestations and appropriate treatments of such central nervous system toxicity were summarized.Results The main clinical manifestations were off-the-point answers,poor sleep,emotional excitement,irritability and inability to recognize others.This medication was discontinued immediately and symptomatic treatment with olanzapine was provided.The symptoms disappeared after three days,and the patient resumed the treatment with loratinib tablets after a week at a smaller dose.Conclusion Clinicians should be alert to the central nervous system toxicity associated with loratinib tablets,which can impact the quality of life of patients.