奥沙利铂对糖尿病与否的胃肠肿瘤神经毒性影响的观察
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摘要
目的观察奥沙利铂化疗对胃肠肿瘤合并糖尿病患者(试验组)与无糖尿病胃肠肿瘤患者(对照组)神经毒性的影响。方法选取60例病理确诊的胃肠肿瘤患者,依据是否合并糖尿病将其列入试验组与对照组,每组各30例。两组患者均使用奥沙利铂进行化疗,观察两组患者神经毒性的发生情况。将试验组根据糖尿病病程分为糖尿病病程>5年组及糖尿病病程≤5年组,比较两组神经毒性反应的发生情况。结果试验组与对照组相比,神经毒性反应发生率为93.3%vs 70.0%,神经毒性的发生时间为(7.8±2.6)周vs (10.3±2.6)周,出现神经毒性时奥沙利铂的累积使用剂量为(563±175)mg vs (746±185)mg,差异有统计学意义(P<0.05)。将试验组根据糖尿病病程分为糖尿病病程>5年组及糖尿病病程≤5年组,结果显示,糖尿病病程>5年组与糖尿病病程≤5年组相比,神经毒性的发生时间为(6±2)周vs(9.5±1.6)周,出现神经毒性时奥沙利铂的累积使用剂量为(440±141)mg vs (685±107)mg,差异有统计学意义(P<0.05)。结论使用奥沙利铂化疗,存在糖尿病合并症的胃肠肿瘤患者神经毒性的发生率更高,发生时间更早,奥沙利铂的累积使用剂量更少。糖尿病病程越长,神经毒性的发生时间更早、奥沙利铂的累积使用剂量更少,要及早的防治。
Objective To observe the effect of oxaliplatin chemotherapy on neurotoxicity in patients with gastrointestinal neoplasms(test group) and patients without diabetes mellitus(control group). Methods 60 patients with pathologically confirmed gastrointestinal tumors were enrolled. According to whether they had diabetes, they were included in the experimental group and the control group, 30 cases in each group. Oxaliplatin was used for chemotherapy in both groups to observe the occurrence of neurotoxicity in the two groups. The experimental group was divided into two groups according to the course of diabetes: the course of diabetes>5 years and the course of diabetes ≤5 years. The incidence of neurotoxicity was compared between the two groups. Results Compared with the control group, the incidence of neurotoxicity was 93.3% vs 70.0%, and the time of neurotoxicity was(7.8±2.6)weeks vs(10.3±2.6)weeks. The accumulation of oxaliplatin in the presence of neurotoxicity dose was(563±175)mg vs(746±185)mg, the difference was statistically significant(P<0.05). According to the course of diabetes, the experimental group was divided into the diabetic course >5 years group and the diabetes course ≤5 years group. The results showed that the duration of neurotoxicity was(6±2)weeks vs(9.5±1.6)weeks compared with the diabetic disease course ≤5 years group, the cumulative dose of oxaliplatin was(440±141)mg vs(685±107)mg when neurotoxicity occurred, and the difference was statistically significant(P<0.05). Conclusion With oxaliplatin chemotherapy, patients with gastrointestinal tumors with diabetes mellitus have a higher incidence of neurotoxicity, occurring earlier, and oxaliplatin has a lower cumulative dose. The longer the course of diabetes, the earlier the occurrence of neurotoxicity, the less cumulative dose of oxaliplatin, and the early prevention and treatment is nessary.
Objective To observe the effect of oxaliplatin chemotherapy on neurotoxicity in patients with gastrointestinal neoplasms(test group) and patients without diabetes mellitus(control group). Methods 60 patients with pathologically confirmed gastrointestinal tumors were enrolled. According to whether they had diabetes, they were included in the experimental group and the control group, 30 cases in each group. Oxaliplatin was used for chemotherapy in both groups to observe the occurrence of neurotoxicity in the two groups. The experimental group was divided into two groups according to the course of diabetes: the course of diabetes>5 years and the course of diabetes ≤5 years. The incidence of neurotoxicity was compared between the two groups. Results Compared with the control group, the incidence of neurotoxicity was 93.3% vs 70.0%, and the time of neurotoxicity was(7.8±2.6)weeks vs(10.3±2.6)weeks. The accumulation of oxaliplatin in the presence of neurotoxicity dose was(563±175)mg vs(746±185)mg, the difference was statistically significant(P<0.05). According to the course of diabetes, the experimental group was divided into the diabetic course >5 years group and the diabetes course ≤5 years group. The results showed that the duration of neurotoxicity was(6±2)weeks vs(9.5±1.6)weeks compared with the diabetic disease course ≤5 years group, the cumulative dose of oxaliplatin was(440±141)mg vs(685±107)mg when neurotoxicity occurred, and the difference was statistically significant(P<0.05). Conclusion With oxaliplatin chemotherapy, patients with gastrointestinal tumors with diabetes mellitus have a higher incidence of neurotoxicity, occurring earlier, and oxaliplatin has a lower cumulative dose. The longer the course of diabetes, the earlier the occurrence of neurotoxicity, the less cumulative dose of oxaliplatin, and the early prevention and treatment is nessary.
引文
[1]高琳,叶山东.2型糖尿病合并恶性肿瘤的临床特点分析[J]中国糖尿病杂志,2015,23(10):873-876.
[2]Hiroshi N,Atsushi G,Tetsuro T,et al.Latest insights into the risk of cancer in diabetes[J].Journal of Diabetes Investion2013,4(3):225-232.
[3]王慧卿,王桂英,尉杰忠.2型糖尿病合并恶性肿瘤患者临床特点分析[J].肿瘤研究与临床,2016,28(6):404-406.
[4]乔晓娟,李昊昌,李云霞.化疗对乳腺癌病人血糖代谢的影响[J].内蒙古医科大学学报,2013,35(5):390-392.
[5]卢瑜,方勇,王青青,等.糖尿病与恶性肿瘤关系的回顾性临床研究[J].中华内分泌代谢杂志,2010,26(3):183-187.
[6]Stein KB,Snyder CF,Barone BB et a1.Colorectal cancer outcomes,recurrence,and complications in persons with and without diabetes mellitus:a systematic review and meta-analysis[J].Dig Dis Sci,2010,55(7):1839-1851.
[7]Srokowski TP,Fang S,Honobagyi GN,et a1.Impact of diabetes mellitus on complications and outcomes of adjuvant chemotherapy in older patients with breast cancer[J].J Clin Oncol,2009,27(13):2170-2176
[8]丁学峰.研究紫杉醇对合并糖尿病及无糖尿病的肿瘤患者化疗后神经毒性的相关性[J].糖尿病新世界,2015,35(18):57-58.
[9]薛英杰,谷丽平,薛同国,等.紫杉醇对有无糖尿病肿瘤患者所致神经毒性的临床研究[J].河北医科大学学报,2014,34(11):1440-1442.
[10]吴胜利,潘巧云,吴克雄,等.糖尿病与恶性肿瘤相关性的作用机制研究[J].转化医学电子杂志,2016,3(4):14-16.
[2]Hiroshi N,Atsushi G,Tetsuro T,et al.Latest insights into the risk of cancer in diabetes[J].Journal of Diabetes Investion2013,4(3):225-232.
[3]王慧卿,王桂英,尉杰忠.2型糖尿病合并恶性肿瘤患者临床特点分析[J].肿瘤研究与临床,2016,28(6):404-406.
[4]乔晓娟,李昊昌,李云霞.化疗对乳腺癌病人血糖代谢的影响[J].内蒙古医科大学学报,2013,35(5):390-392.
[5]卢瑜,方勇,王青青,等.糖尿病与恶性肿瘤关系的回顾性临床研究[J].中华内分泌代谢杂志,2010,26(3):183-187.
[6]Stein KB,Snyder CF,Barone BB et a1.Colorectal cancer outcomes,recurrence,and complications in persons with and without diabetes mellitus:a systematic review and meta-analysis[J].Dig Dis Sci,2010,55(7):1839-1851.
[7]Srokowski TP,Fang S,Honobagyi GN,et a1.Impact of diabetes mellitus on complications and outcomes of adjuvant chemotherapy in older patients with breast cancer[J].J Clin Oncol,2009,27(13):2170-2176
[8]丁学峰.研究紫杉醇对合并糖尿病及无糖尿病的肿瘤患者化疗后神经毒性的相关性[J].糖尿病新世界,2015,35(18):57-58.
[9]薛英杰,谷丽平,薛同国,等.紫杉醇对有无糖尿病肿瘤患者所致神经毒性的临床研究[J].河北医科大学学报,2014,34(11):1440-1442.
[10]吴胜利,潘巧云,吴克雄,等.糖尿病与恶性肿瘤相关性的作用机制研究[J].转化医学电子杂志,2016,3(4):14-16.