己酮可可碱预防肺癌患者紫杉醇化疗致外周神经毒性的研究

Pentoxifylline prevents peripheral neurotoxicity induced by paclitaxel chemotherapy in patients with lung cancer

目的观察口服己酮可可碱在预防肺癌患者应用紫杉醇化疗的外周神经毒性的效果。方法选取2021年6月至2022年6月收治的肺癌患者70例,均采用紫杉醇+免疫检查点抑制剂联合方案治疗,随机分为对照组和观察组,每组35例。对照组口服安慰剂,观察组口服己酮可可碱0.4 g,2次/d,预防神经毒性。治疗期间,观察2组患者是否出现外周神经毒性症状并详细记录出现症状的时间、症状表现、Karnofsky(KPS)评分及出现神经毒性时紫杉醇的使用剂量。分别在2、4个周期治疗结束及化疗结束6个月时,对比2组患者外周神经毒性情况。结果治疗2、4个周期后及化疗结束6个月后,与对照组比较,观察组患者出现外周神经毒性症状的概率以及症状严重程度均较低(P<0.05)。同时,观察组患者在治疗期间出现外周神经毒性症状的时间也晚于对照组(P<0.05),观察组患者比对照组能更多的按照标准剂量使用紫杉醇(P<0.05)。治疗后,观察组的KPS评分为(74.23±6.32)分,高于对照组的(70.56±6.64)分(P<0.05)。观察组治疗费用、平均住院日均低于对照组,观察组疗效优于对照组。结论己酮可可碱对于紫杉醇所致神经毒性有一定的预防作用。

Objective To observe the preventive effect of pentoxifylline on peripheral neurotoxicity in lung cancer patients treated with paclitaxel chemotherapy.Methods A total of 70 patients with lung cancer admitted from June 2021 to June 2022 in our hospital were randomly selected.All patients were treated with paclitaxel combined with immune checkpoint inhibitors.They were randomly divided into two groups:observation group(n=35)and control group(n=35).Patients in the control group were treated with placebo,and those in the observation group were treated with oral pentoxifylline 0.4 g,twice a day to prevent neurotoxicity.The time of symptom onset of peripheral neurotoxicity,performance,the Karnofsky Performance Scale(KPS)score and dosage of paclitaxel used when neurotoxicity occurred were recorded.Peripheral neurotoxicity was evaluated after 2 and 4 cycles of treatment and 6 months after chemotherapy.The time of peripheral neurotoxic symptoms,symptoms,KPS score and the dose of paclitaxel were observed and recorded in detail.Results After 2 and 4 cycles of treatment and 6 months after chemotherapy,the incidence and severity of peripheral neurotoxicity in the observation group were significantly lower than those of the control group(P<0.05).During the treatment,the onset of peripheral neurotoxicity in the observation group was significantly later than that of the control group(P<0.05),and more patients in the observation group were able to use paclitaxel according to the standard dose than those in the control group(P<0.05).After treatment,the KPS score of the observation group was significantly higher than that of the control group(74.23±6.32 points vs 70.56±6.64 points,P<0.05).The treatment cost and average length of stay were significantly lower in the observation group than those of the control group.The efficacy was superior in the observation group than the control group.Conclusion Pentoxifylline prevents paclitaxel-induced neurotoxicity in lung cancer patients to a certain extent.