静滴左卡尼汀预防化疗药物神经毒性的临床观察

目的：评价左卡尼汀对化疗药物神经毒性的防治效果.方法：42例肿瘤患者,随机进入左卡尼汀组（化疗药物给药前静脉注射左卡尼汀1500mg/m2,n=21）或对照组（化疗药物给药前静脉注射还原性谷胱甘肽1500mg/m2,n =21）.化疗第2、4、6周期详细评价外周感觉神经毒性分级、肿瘤相关性疲劳分级和体力状况评分以及行神经电生理检查.结果：左卡尼汀组Ⅲ-Ⅳ度神经毒性发生率与对照组相比,为9.5％∶55％（P=0.001）,肿瘤相关性疲劳分级3-4级患者发生率显著降低,（57.1％∶90％,P=0.017）.化疗近期有效率左卡尼汀组与对照组差异无显著性（33.3％∶40％,P =0.760）.结论：左卡尼汀对化疗药物引起的神经毒性有明显防治作用,不降低化疗疗效.

Preventing effect of levocarnitine on chemotherapy-related neurotoxicity in patients with malignant tumors

Objective：To assess the clinical efficacy of levocarnitine in preventing neurotoxicity induced by chemotherapy.Methods：A total of 42 patients with malignant tumors were enrolled,and randomly assigned to receive levocarnitine（1500mg/m2） （n =21） or glutamine（1500mg/m2） （n =21） just before chemotherapy.All patients received taxel based or platinum based or vinblastine based regimen.Neurological toxicity and efficacy of chemotherapy were assessed.Results：The occurrence rates of grade Ⅲ-Ⅳ peripheral neurotoxicity after chemotherapy were significantly lower in levocarnitine group than in control group.（9.5％ vs 55％,P =0.001）.The occurrence rates of grade Ⅲ-Ⅳ tumor related fatigue were significantly lower in levocarnitine group than in control group （57.1％ vs 90％,P=0.017）.The overall response rates of evaluable patients were 33.3％ in levocarnitine group and 40％ in control group（P =0.760）.Conclusion：Levocarnitine could significantly reduce the occurrence and severity of peripheral neurotoxicity caused by chemotherapy,but not affect response to chemotherapy.