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周剂量紫杉类预处理方案的临床研究——紫杉类与铂类药物联合治疗晚期非小细胞肺癌
作者:叶茁1 黄新恩2 林勇3 
单位:1.东南大学,临床医学院,江苏,南京,210009; 2.江苏省肿瘤医院,肿瘤内科,江苏,南京,210009; 3.东南大学附属中大医院,呼吸内科,江苏,南京,210009
关键词:非小细胞肺癌 紫杉醇 多西紫杉醇 预处理 
分类号:R979.1, R734.2
出版年·卷·期(页码):2007·26·第二期(120-123)
摘要:

目的:观察几种周剂量紫杉类化疗预处理方案的安全性以及不良反应,探索最佳周剂量紫杉类预处理方法.方法:紫杉醇50~65mg·m-2静脉滴注>3h,第1天,每周1次,连续2~3周,联合铂类,28d重复(17例).多西紫杉醇60mg静脉滴注1h,第1、8、15天,联合顺铂60~90mg·m-2,28d重复(9例).采用多种预处理方式.结果:预处理相关的毒副反应包括过敏性反应1例,低钾血症5例,肌无力2例,呃逆1例,水钠潴留2例,感染2例.结论:我们推荐的周剂量紫杉类化疗预处理方案为:(1)使用紫杉醇前12及2h,口服地塞米松2.25~7.5mg;(2)使用多西紫杉醇前1d、当日和第2天口服地塞米松4.5~7.5mg,每日2次.均于化疗前30min予止吐药、H2受体拮抗剂和抗组胺药.

Objective To study the safety and adverse reactiones of the pre-medication for weekly paclitaxel/docetaxel chemotherapy on non-small cell lung cancer,and investigate optimal pre-medication methods.Methods 17 cases were treated with paclitaxel 50-65mg·m-2 every week combining platinum,9 cases with docetaxel 60mg every week combining cisplatin.Each cycle consisted of two or three consecutive weekly taxane followed by 1 week rest.Four pre-medications were attempted.Result The adverse reactions of pre-medications included: hypersensitivity(1 case),hypopotassemia(5 cases),myasthenia(2 cases),hiccup(1 case),retention of water and sodium(2 cases),infection(2 cases).Conclusions Our recommendations for weekly taxane pre-medication are the following: dexamethasone 2.25-7.5mg orally 12 h and 2 h before paclitaxel,antihistaminic and an H2-blocker 30min before paclitaxel;dexamethasone 4.5-7.5mg bid,orally for three consecutive days(d-1,d 0 and d 2),antihistaminic and an H2-blocker 30min before docetaxel.

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