The impact of diabetes mellitus on the toxicity of therapy for advanced ovarian cancer
The impact of diabetes mellitus on the toxicity of therapy for advanced ovarian cancer
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DOI：
10.1006/gyno.1996.0090
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发表时间：
1996-04-01
影响因子：
4.7
通讯作者：
Spriggs, DR
中科院分区：
文献类型：
--
作者：
Gogas, H;Shapiro, F;Spriggs, DR
为了获得关于神经毒性、肾毒性以及地塞米松对接受紫杉醇和/或顺铂治疗的糖尿病上皮性卵巢癌患者高血糖频率和严重程度影响的更准确信息，进行了一项回顾性研究。 10 年期间，从 1254 名患者中鉴定出 33 名患者。在接受顺铂治疗的患者中，24 名患者中有 21 名 (67%) 出现神经系统症状进展，三名患者出现 3 级感觉神经病变，两名患者出现耳毒性。 4 名患者有轻度肾毒性的证据，其中 2 名患者需要减少 50% 的剂量。在接受紫杉醇治疗的患者组中，18 例患者中有 9 例（50%）出现症状进展，2 例达到 3 级，2 例出现耳毒性。无需因神经病变而停止治疗，也没有患者有药物引起的自主神经系统功能障碍的证据。高血糖经常加剧，5名患者需要改变治疗，但没有患者因此住院。我们的结果表明，紫杉醇/顺铂联合方案或单独紫杉醇可以以标准剂量安全地用于糖尿病患者，同时监测血糖和肌酐，以及神经系统症状史和体检。 (C) 1996 学术出版社
A retrospective review was undertaken to obtain more precise information about neurotoxicity, nephrotoxicity, and the effects of dexamethasone on the frequency and severity of hyperglycemia in diabetic patients with epithelial ovarian cancer treated with paclitaxel and/or cisplatin. Thirty-three patients were identified from 1254 patients over a 10-year period. In the cisplatin-treated patients, 21 of 24 (67%) had progression of neurological symptoms, three experienced grade 3 sensory neuropathy, and two had ototoxicity. Four patients had evidence of mild nephrotoxicity and two required a 50% dose reduction. In the group of patients treated with paclitaxel, 9 of the 18 (50%) had progression of symptoms, 2 to grade 3, and 2 had ototoxicity. No discontinuation of therapy due to neuropathy was required and no patient had evidence of drug-induced autonomic nervous system dysfunction. Hyperglycemia was frequently exacerbated, and 5 patients required treatment change, but no patient was hospitalized in relation to this. Our results indicate that the paclitaxel/cisplatin combination regimen or paclitaxel alone could be safely administered in diabetic patients at standard doses, with concurrent glucose and creatinine monitoring, as well as history of neurological symptoms and physical examination. (C) 1996 Academic Press, Inc.