| 谷胱甘肽预防恶性淋巴瘤长春新碱化疗所致神经毒性的临床研究 |
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| 引用本文： | 黄瑞霞, 李鑫, 孙振昌, 张蕾, 李玲, 王新华, 张明智. 谷胱甘肽预防恶性淋巴瘤长春新碱化疗所致神经毒性的临床研究[J]. 中国肿瘤临床, 2011, 38(23): 1468-1470. DOI: 10.3969/j.issn.1000-8179.2011.23.013 |
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| 作者姓名： | 黄瑞霞 李鑫 孙振昌 张蕾 李玲 王新华 张明智 |
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| 作者单位： | 郑州大学第一附属医院肿瘤内科(郑州市 450052) |
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| 摘 要： | 恶性淋巴瘤发病率及死亡率逐年上升，长春新碱是治疗恶性淋巴瘤的一线化疗药物，而其突出的剂量限制性神经毒性使其临床应用明显受限。本研究旨在评价谷胱甘肽对恶性淋巴瘤长春新碱化疗所致神经毒性的预防作用。方法：100例行CHOP方案或R-CHOP方案化疗的弥漫大B细胞淋巴瘤患者，随机进入谷胱甘肽组和对照组。每2个周期评价神经毒性及近期疗效。结果：谷胱甘肽组和对照组Ⅰ~Ⅱ级神经毒性发生率分别为26.5%（13/49）、47.1%（24/51），Ⅲ～Ⅳ级神经毒性发生率分别为6.1%（3/49）、23.5%（12/51），谷胱甘肽组神经毒性发生率均低于对照组，两组差异有统计学意义（P<0.05）；6个周期后化疗有效率分别为83.7%（41/49）、82.4%（42/51），两组差异无统计学意义（P>0.05）。结论：谷胱甘肽对含长春新碱方案化疗所致的神经毒性有明显的预防作用，同时不影响化疗疗效。
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| 关 键 词： | 谷胱甘肽 恶性淋巴瘤 长春新碱 化疗 神经毒性 |
| 收稿时间： | 2011-07-31 |
| 修稿时间： | 2011-09-29 |
Clinical Efficacy of Glutathione for Preventing Vincristine Neurotoxicity during Chemotherapy for Malignant Lymphomas |
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| Ruixia HUANG, Xin LI, Zhenchang SUN, Lei ZHANG, Ling LI, Xinhua WANG, Mingzhi ZHANG. Clinical Efficacy of Glutathione for Preventing Vincristine Neurotoxicity during Chemotherapy for Malignant Lymphomas[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2011, 38(23): 1468-1470. DOI: 10.3969/j.issn.1000-8179.2011.23.013 |
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| Authors: | Ruixia HUANG Xin LI Zhenchang SUN Lei ZHANG Ling LI Xinhua WANG Mingzhi ZHANG |
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| Affiliation: | Department of Medical Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China |
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| Abstract: | The incidence and mortality rate of malignant lymphoma has arisen steadily over the past decade. Vincristine is one of the first-line chemotherapeutic agents used for treating malignant lymphoma, but dose-dependent neurotoxicity can restrict the clinical application of this medicine. This study aims to access the clinical efficacy of glutathione for preventing vincristine-induced neurotoxicity during chemotherapy in lymphoma patients. Methods: One hundred malignant lymphoma patients who received CHOP or R-CHOP regimens including vincristine were randomized into two groups: the glutathione group treated intravenously with glutathione before chemotherapy ( n = 49 ), and the control group ( n = 51 ). The degree of neurotoxicity and the chemotherapeutic efficacy were evaluated every two treatment cycles. The degree of neurotoxicity was accessed by the WHO Toxicity Criteria Scale and the chemotherapeutic effect was evaluated using the Cheson Criteria. Results: The incidence rate of grade I-II and grade III-IV neurotoxicity after chemotherapy was significantly lower in the glutathione group compared to the control group (26.5% vs. 47.1%, P < 0.05; 6.1% vs. 21.6%, P < 0.05 ). In contrast, glutathione pretreatment did not influence clinical efficacy, as overall response after six cycles were 83.7% in the glutathione group and 82.4% in the control group ( P > 0.05 ). Conclusion: The antioxidant glutathione can significantly reduce the occurrence and severity of vincristine-induced neurotoxicity in malignant lymphoma patients without interfering with the clinical efficacy of chemotherapy. |
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| Keywords: | Glutathione Malignant lymphoma Vincristine Chemotherapy Neurotoxicity |
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