J Natl Cancer Inst:乳腺癌女性,紫杉烷诱导的神经病变的2年趋势

2018-07-12 吴星 环球医学

2018年6月,发表在《J Natl Cancer Inst》的一项由美国学者进行的研究,考察了参加乙酰-L-肉碱随机试验(SWOG S0715)的女性中,紫杉烷诱导的神经病变的2年趋势。

2018年6月,发表在《J Natl Cancer Inst》的一项由美国学者进行的研究,考察了参加乙酰-L-肉碱随机试验(SWOG S0715)的女性中,紫杉烷诱导的神经病变的2年趋势。

背景:化疗诱导的周围神经病变(CIPN)是紫杉烷的一种常见和致残的副反应。一项随机试验意外发现乙酰-L-肉碱(ALC)可增加CIPN。研究者考察了该试验的患者中,CIPN的长期模式。

方法:S0715是一项随机、双盲、多中心试验,比较了ALC(1000mg,每天3次)和安慰剂在进行基于紫杉烷的辅助化疗的乳腺癌女性中治疗24周的情况。于12、24、36、52和104周,通过FACT-紫杉烷量表的11条目的神经毒性(NTX)单元测量CIPN。对纵向数据使用线性混合模型,研究者考察了2年的NTX评分。使用线性回归检测了个体时间点。回归分析纳入了分层因素和基线评分作为协变量。所有统计学检验都是双侧的。

结果:409名受试者符合评估标准。与安慰剂组患者相比,接受ALC的患者的NTX评分统计学上显著降低(CIPN变差)-1.39(95% 置信区间[CI]=-2.48~-0.30)(P=0.01)。该差异在24周(-1.68,95% CI=-3.02~-0.33)、36周(-1.37,95% CI=-2.69~-0.04)和52周(-1.83,95% CI=-3.35~-0.32)时尤其显著。104周时,ALC组39.5%和安慰剂组34.4%的患者报告自基线降低5分(10%)。对于两个治疗组,104周的NTX评分都较基线时具有统计学显著差异(P<0.001)。

结论:两组中,NTX评分都自基线降低并始终保持在较低水平。24周的ALC治疗可造成2年统计学显著较差的CIPN。理解该持续效果的机制,有助于预防和治疗策略的制定。到那时,应严格研究常用的补充治疗药物的潜在有效性和危害。

原始出处:

Hershman DL, Unger JM, Crew KD, et.al. Two-Year Trends of Taxane-Induced Neuropathy in Women Enrolled in a Randomized Trial of Acetyl-L-Carnitine (SWOG S0715). J Natl Cancer Inst. 2018 Jun 1;110(6):669-676. doi: 10.1093/jnci/djx259.

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    2018-09-10 liye789132251
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    2018-11-16 drj2003
  4. 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objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Fri Jul 13 09:11:36 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331051, encodeId=f782331051ca, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Jul 12 11:14:08 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331050, encodeId=10c3331050f6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Jul 12 11:13:25 CST 2018, time=2018-07-12, status=1, ipAttribution=)]
    2018-09-03 qidongfanjian
  5. 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objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Fri Jul 13 09:11:36 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331051, encodeId=f782331051ca, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Jul 12 11:14:08 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331050, encodeId=10c3331050f6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Jul 12 11:13:25 CST 2018, time=2018-07-12, status=1, ipAttribution=)]
    2018-07-14 axin012
  6. 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  7. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Jul 12 11:13:25 CST 2018, time=2018-07-12, status=1, ipAttribution=)]
    2018-07-13 神功盖世

    学习

    0

  8. 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channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74389, encryptionId=ecdfe438970, topicName=神经病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0ea69427176, createdName=lingaifan, createdTime=Sat Jul 14 01:56:00 CST 2018, time=2018-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331267, encodeId=8d8533126e98, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Fri Jul 13 09:13:31 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331263, encodeId=9b593312639b, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Fri Jul 13 09:11:36 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331051, encodeId=f782331051ca, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Jul 12 11:14:08 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331050, encodeId=10c3331050f6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Jul 12 11:13:25 CST 2018, time=2018-07-12, status=1, ipAttribution=)]
    2018-07-13 sunfeifeiyang

    学习

    0

  9. 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channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74389, encryptionId=ecdfe438970, topicName=神经病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0ea69427176, createdName=lingaifan, createdTime=Sat Jul 14 01:56:00 CST 2018, time=2018-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331267, encodeId=8d8533126e98, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Fri Jul 13 09:13:31 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331263, encodeId=9b593312639b, content=学习, beContent=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Jul 12 11:13:25 CST 2018, time=2018-07-12, status=1, ipAttribution=)]
    2018-07-12 sunfeifeiyang

    0

  10. 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    2018-07-12 sunfeifeiyang

    学习

    0

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