恶性脑胶质瘤同步放化疗中替莫唑胺化疗的不良反应及对策

doi:10.3969/j.issn.1006-7795.2012.05.007

首都医科大学学报 ›› 2012, Vol. 33 ›› Issue (5): 589-593.doi: 10.3969/j.issn.1006-7795.2012.05.007

恶性脑胶质瘤同步放化疗中替莫唑胺化疗的不良反应及对策

康勋¹, 李珊¹, 谢铮铮², 赵艳杰¹, 姜妮¹, 周蕾, 李文斌¹

1. 首都医科大学附属北京世纪坛医院肿瘤科,北京 100038;2. 首都医科大学附属世纪坛医院药剂科, 北京 100038

收稿日期:2012-06-11 修回日期:1900-01-01 出版日期:2012-10-21 发布日期:2012-10-21
通讯作者: 李文斌

Temozolomide adverse events and coping strategies in malignant glioma patients with concurrent chemoradiotherapy

KANG Xun¹, LI Shan¹, XIE Zheng-zheng², ZHAO Yan-jie¹, JIANG Ni¹, ZHOU Lei, LI Wen-bin¹

1. Department of Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038 China;2. Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China

Received:2012-06-11 Revised:1900-01-01 Online:2012-10-21 Published:2012-10-21

摘要/Abstract

摘要： 目的替莫唑胺是一种新型烷化剂,因其口服给药、生物利用度好、良好的血脑屏障通透性以及突出的治疗效果,已成为恶性脑胶质瘤治疗的常规用药。本文旨在通过对替莫唑胺的不良反应的研究,以期最大限度地减轻药物的不良反应,提高患者的生存质量。方法根据2009年美国卫生与公共服务部制定的药物常见不良事件评价标准第四版(CTCAE-V4.0),观察使用替莫唑胺联合放射治疗的同步放化疗和化学治疗患者所出现的化疗不良反应,并采取积极的防治措施进行处理。结果本组95例接受替莫唑胺联合同步放化治疗的患者中,严格依据CTCAE-V4.0评价原则,得出结果如下:有20 例患者出现胃肠道不良反应, 其中1级的有12例,2级有8例。发生1级中性粒细胞减少的为6例,2级的为3例;1级血小板减少者3例,2级的为1例。发生脱发者为53例,1级的有41例,2级有12例。发生皮疹、斑丘疹共7例,1级的为6例,2级的为1例。所有上诉不良反应较轻,标准均为1-2级,无3、4、5级不良反应发生。在给予对症、停药处理后均能明显缓解。结论替莫唑胺是目前胶质瘤治疗的常用药物,通过对替莫唑胺联合放射治疗过程中的不良反应,显示其不良反应较轻微,且给予对症处理后均能明显缓解。因此,在对恶性脑胶质瘤患者使用同步放射治疗化学治疗中,替莫唑胺的应用是安全的。

关键词: 恶性脑胶质瘤, 替莫唑胺, 不良反应

Abstract: Objective Radiotherapy has been of key importance to the treatment of malignant gliomas for decades, and the ability to focus the beam and tailor it to the irregular contours of brain tumors and minimize the dose to nearby critical structures with intensity modulated or image-guided techniques has improved greatly. Temozolomide, an alkylating agent given in simple oral route of administration,is used in conjunction with and after radiotherapy. This study aimed to evaluate the toxic effects of temozolomide when used incombination with radiotherapy, to observe the side effects of temozolomide, evaluate the clinical safety of the drug, and improve the quality of life in patients with glioma.Methods Based on the Common Terminology Criteria forAdverse Events (CTCAE) Version 4.0, the authors observed the toxicity of temozolomide in patients with concurrent chemoradiotherapy, and take active measures to deal with the toxicity. Results here were 95 patients who received concurrent chemoradiotherapy, 20 patients had the symptoms of nausea, vomiting and loss of appetite, according to CTCAE-V4.0, 12 cases were grade 1, 8 cases were grade 2. 9 patients had neutropenia, 6 of them were grade 1, 3 cases were grade 2. In the aspect of thrombocytopenia, 3 cases were grade 1, 1 case was grade 2. Mucocutaneous adverse reactions were observed in 7 cases, 6 cases were grade 1, 1 case was grade 2. One patient had symptoms of palpitation, the evaluation was grade 2. All patients had mild symptoms of adverse drug reactions, but the symptoms could significantly relieve after symptomatic treatment and withdrawal of the treatment. Conclusion Temozolomide is commonly used in the treatment of malignant glioma, the toxic and side effects were observed during the process of concurrent chemoradiotherapy, the toxic and side effects were minor, and can be relieved obviously after symptomatic treatment. Therefore, temozolomide is a safe drug for malignant glioma treatment.

Key words: malignant glioma, Temozolomide, side effect

中图分类号:

R 739.41

康勋;李珊;谢铮铮;赵艳杰;姜妮;周蕾;李文斌. 恶性脑胶质瘤同步放化疗中替莫唑胺化疗的不良反应及对策[J]. 首都医科大学学报, 2012, 33(5): 589-593.

KANG Xun;LI Shan;XIE Zheng-zheng;ZHAO Yan-jie;JIANG Ni;ZHOU Lei;LI Wen-bin. Temozolomide adverse events and coping strategies in malignant glioma patients with concurrent chemoradiotherapy[J]. Journal of Capital Medical University, 2012, 33(5): 589-593.

[1]	常忠莲, 盛晓滨, 石新兰, 韦薇. 桂枝茯苓汤辨证加味对晚期宫颈癌化学药物治疗患者的增效减毒作用[J]. 首都医科大学学报, 2018, 39(4): 596-601.
[2]	于迎, 庄红艳, 尹冬青, 杜渐, 杨静, 贾竑晓. 中医体质类型与抗精神病药物不良反应的关系研究[J]. 首都医科大学学报, 2018, 39(2): 204-208.
[3]	刘俊华, 王勇, 王颜颜, 王晓民. 深部脑磁刺激对帕金森病模型大鼠运动症状治疗的安全性评价[J]. 首都医科大学学报, 2017, 38(2): 260-267.
[4]	张勇, 陈文明, 周合冰. 193例成人免疫性血小板减少症临床分析[J]. 首都医科大学学报, 2014, 35(5): 560-565.
[5]	蒋雪云, 张颖洁, 赵明. 超黄金治疗期的缺血性中风大鼠模型、治疗模式及疗效表述[J]. 首都医科大学学报, 2014, 35(1): 108-112.
[6]	张利勇;王威;王保国. 丙泊酚不良反应的多中心和大样本调查[J]. 首都医科大学学报, 2006, 27(2): 255-257.
[7]	焦希平;史中华;王保国;董佳;刘敏. 罗库溴铵用于气管插管的临床观察[J]. 首都医科大学学报, 2005, 26(4): 495-497.
[8]	王育琴;张建;王香平;王力红;刘佑琴;魏嘉平;冯明;聂秀红;杨强;张泰昌;李宗信;王克杰;续大田;韩玫;李坤成;尹建国;王立;吴晓光;汤哲. SARS患者使用糖皮质激素的不良反应及其相关影响因素研究[J]. 首都医科大学学报, 2003, 24(4): 447-450.
[9]	徐宝荣. 倍欣治疗60例2型糖尿病的临床观察[J]. 首都医科大学学报, 2001, 22(3): 230-231.

恶性脑胶质瘤同步放化疗中替莫唑胺化疗的不良反应及对策

Temozolomide adverse events and coping strategies in malignant glioma patients with concurrent chemoradiotherapy

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 9

编辑推荐

Metrics

本文评价