口服小分子靶向抗肿瘤药物的不良反应及防治措施(3)

[16]　FUKUOKAM,YANOS,GIACCONEG,etal.Multi2institution2

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中国新药杂志2009年第18卷第18

期

靶向制剂,靶向制剂研究,靶向性药物,靶向性药物评价

ChineseJournalofNewDrugs2009,18(18

)

视网膜光凝,而最终的视力并无改善。Chu等

[2]

报

2008年8月化疗后身体反应强烈,多处皮肤疼痛也

道大剂量顺铂由于意外代替卡铂使用并且未水化处理,结果造成严重不良反应,包括失明。

紫杉醇是新型抗微管药物,用于卵巢癌和乳腺癌及NSCLC的一线和二线治疗,说明书资料里不良反应主要有:过敏反应、骨髓抑制、神经毒性、心血管毒性、胃肠道反应、肝脏毒性、脱发、局部反应等,紫杉醇导致神经症状的发生率与严重程度是剂量依赖性的,其导致肌肉关节疼痛的发生率和严重程度也

[3]

呈剂量依赖性。国内有1篇综述中提到紫杉醇引起的眼毒性有闪光幻觉(视野内有闪光)和局部缺血性视神经病,Scaioli等报道对30例乳腺癌患者单用紫杉醇或联合阿霉素的患者分别在第、6,诱发电位、,上述资料表明伤,并与剂量有关。本案患者经多个疗程后出现视力失明,经头颅MR平扫,影像学诊断结果与其失明无关,其化疗方案符合常规标准,由于先前做过多次化疗(具体不详),不排除累积剂量较大,患者于

[4]

可能与累积剂量有关。而患者又在化疗的间隙做中草药辅助治疗,虽然说导致失明的影响因素很复杂,但药物的毒副作用是客观存在的。该案例提醒我们,在使用紫杉醇联合顺铂治疗疗程较多累积剂量较大时,是否应考虑到患者可能出现的眼毒性并制订相应的预防计划。

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