还原型谷胱甘肽用于预防和降低奥沙利铂周围神经毒性的研究

中华肿槠防治杂志 2010 年丨2 月笫 17 卷笫 2.丨期 CHIN J CANCER PREV TREAT ，December 2010. Vol. 17 No. 24 • 2057 •

还原型谷胱甘肽用于预防和降低奥沙利铂 周围神经毒性的研究

庞丹梅，邓燕明，蓝晓珊，冯卫能，梁剑苗，徐绮华 佛山市第一人民医院肿瘤内科，广东佛山528041 Efficacy of reduced glutathione in preventing and reciucing neurotoxicity of oxaliplatin

PANG Dan-mei % DENG Yan-ming, LAN Xiao-shan % FENG Wei-neng t LIANGJian-mia 〇t XV Yi-hua Department of Medical Oncology* First People* s Hospital of Foshan City y Foshan 528041, P. R. China 【摘要】 目的：观察还原型谷胱甘肽 (GSH )预防和降低奥沙利铂周围神经毒性 的作用。方法：将78例肠癌术后和胃癌术 后准备进行FOLFOX 4或mFOLFOX 6方案 化疗的患者，随机分为GSH 组40例和对照 组38例，GSH 组在奥沙利铂化疗每周期 同时给予GSH 1.8 g /d ,l 次/d •加入生理盐 水100 mU 共3 d (化疗前1 d 、当日和第2 天）。对照组在化疗每周期同时给予生理盐 水

100 mU 共3 d (化疗前1 d 、当日和第2 天>,在治疗前、化疗4个周期后、化疗8个 周期后及化疗12个周期后分别记录临床感 觉神经系统检查結果，并记录奥沙利铂周围 神经毒性级别•有神经毒性症状的患者随 访1年•每3个月复查1次临床感觉神经系统检查。

结果：在治疗前、化疗4个周期、化 疗8个周期后GSH 组与对照组的周围神经 毒性发生率差异无统计学意义，F >0. 05。 完成12个用期化疗后GSH 组3级周图神经毒性发生率为15%,4级周围神经毒性发生率为0,对照组3级周围神经毒性发生率为39. 5%, 4级周围神经毒性发生率为 5. 3%,3〜4级神经毒性两组间差异有统计学意义.P <0.05•随访1年后，GSH 组>2 级神经毒性发生率为0,1级神经毒性发生 率为7.5%(3例）；对照组>2级神经毒性发 生率为0，1级神经毒性发生率为23.7%(9 例两组差异有统计学意义，P <0. 05。结 论：化疗时使用GSH 可以预防和减少奥沙 利铂所致周围神经毒性， 中华肿痛防治杂志.2010,17(24) :

2057—2059 [ABSTRACT] OBJECTIVE: To observe the efficacy of reduced glutathione in prevention and reduction of oxalipatin-inducted neu- rotoxidty.METHODS :Seventy-eightpatiemsa ftergasticandcoh onreclal cancer resection treated with FOLFOX4 or mF()LFOX6 regimen were randomized into reduced glutathione group (GSH group) and control group. Forty patients were entered in GSH group and thirty-eight patients in control

group. One day before chemotherapy with oxalipJatin. the day with chemotherapy and the day after chemotherapy* the GSH group patients received infusion of 1. 8 g of reduced glutatione intravenously wtih NS 】00 niL. while the control group patients received NS 100 mL in the three day with chemotherapy. The neurotoxity evaluation was performed before the treatment, after the fourth cycly» the eighth cycly and the twelfth cycle of treatment. The patients who had the neurotoxity symptoms were followed up for one year. The clinical sensory nervous system examination was checked every three months. RESULTS ： After the fourth and the eithth cycle» the incidence of neurotoxicity between the two groups was not significantly different (P>0. 05). After the twelfth cycle > the incidence of grade 3 and 4 periphery neurotoxicity in the control group was 39. 5%* and 5.3%. The incidence of grade 3 and 4 periphery

neurotoxicity in the GSH group was 15%. and 0%. The incidence of grade 3 to 4 periphery neurotoxicity between the two groups was significantly different(P

grade 1 periphery neurotoxicity was 9(23. 7%) patients experienced in the control group compared with only 3(7. 5^) patients

【关键词】胃肿瘤/药物疗法；肠肿瘤/药物疗法；还原型谷胱甘肽；奥沙利铂；用围神经毒性 [KEYWtMIDS] stomach neoplasms/drug therapy ； intestinal neoplasms/drug therapy; reduced glutathione ； oxaliplatin ； neurotoxity 【中图分类号】R 735.2 R 735.3 【文献标识码】 A 【文章编号】 1673-5269(2010)24-2057-03 【基金项目】佛山市科技局重点科技攻关项目（200708072)

【通讯作者简介】庞丹梅，女，天津人，主任医师，主要从事恶性肿瘤化疗的临床研究工作， Tel ：86 —757 —83161135 E-mail

： pdmei@fsyyy. com