Prophylaxis of mucosal toxicity by oral propantheline and cryotherapy in children with malignancies undergoing myeloablative chemo-radiotherapy
Prophylaxis of mucosal toxicity by oral propantheline and cryotherapy in children with malignancies undergoing myeloablative chemo-radiotherapy
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DOI：
10.1620/tjem.210.315
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发表时间：
2006-12-01
影响因子：
2.2
通讯作者：
Imaizumi, Masue
中科院分区：
文献类型：
--
作者：
Sato, Atsushi;Saisho-Hattori, Takako;Imaizumi, Masue
粘液毒性是恶性肿瘤儿童强化放化疗的一种致残性并发症，给身体和心理带来痛苦。因此，重要的是尽量减少这些患者的粘膜毒性。在这份报告中，口服冷却（冷冻疗法）和丙胺太林，一种抗胆碱能药物的管理，联合预防的效果进行了研究，在急性白血病或实体瘤患者（年龄2-16岁），谁接受清髓性放化疗和自体外周血干细胞救援从1993年至1997年。患者接受联合预防（n = 12）或单一预防（n = 5）预治疗，或未接受治疗（n = 7）。联合预防显著降低了重度粘膜炎（联合，8.3%;单一，20.0%;和未治疗，42.9%）和重度腹泻（联合，16.7%;单一，60.0%;和未治疗，57.1%）。此外，联合预防倾向于缩短定义为体温> 38 ℃的发热事件的时间（联合，3.8天;单次，4.6天;未治疗，5.6天）。因此，丙胺太林与口腔冷冻联合应用可能是降低接受大剂量化疗的恶性肿瘤患者粘膜毒性的可行且有效的方法。
Mucosal toxicity is an incapacitating complication of intensive chemo-radiotherapy for children with malignant disorders, and is physically and psychologically distressful. It is therefore important to minimize mucosal toxicity in those patients. In this report, the effects of the combined prophylaxis of oral cooling (cryotherapy) and administration of propantheline, an anticholinergic drug, were studied in patients (aged 2-16 year) with acute leukemias or solid tumors, who underwent myeloablative chemo-radiotherapy and autologous peripheral blood stem cell rescue from 1993 to 1997. Patients were pretreated with the combined prophylaxis (n = 12) or single prophylaxis (n = 5), or left untreated (n = 7). The combined prophylaxis significantly reduced the severe mucositis (combined, 8.3%; single, 20.0%; and untreated, 42.9%) and severe diarrhea (combined, 16.7%; single, 60.0%; and untreated, 57.1%). Moreover, the combined prophylaxis tended to shorten the periods of febrile episodes defined as temperature > 38 degrees C (combined, 3.8 days; single, 4.6 days; and untreated, 5.6 days). Therefore, the combination of propantheline and oral cryotherapy may be feasible and effective for reduction of mucosal toxicity in patients with malignancy who undergo high-dose chemotherapy.