A pilot study on the effect of acetyl-L-carnitine in paclitaxel-and cisplatin-induced peripheral neuropathy
A pilot study on the effect of acetyl-L-carnitine in paclitaxel-and cisplatin-induced peripheral neuropathy
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DOI：
10.1177/030089160509100206
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发表时间：
2005-03-01
期刊：
影响因子：
1.9
通讯作者：
Crinò, L
中科院分区：
文献类型：
--
作者：
Maestri, A;Ceratti, ADP;Crinò, L
目的和背景：除了骨髓抑制和肾毒性外，神经毒性是广泛使用的化疗药物如紫杉烷类、顺铂和长春花生物碱的常见副作用。神经毒性可导致抗肿瘤治疗中止或剂量方案调整。本探索性研究的目的是探讨活性乙酰-L-肉毒碱逆转周围神经病变患者化疗引起的周围neuropathy.Methods和研究设计：27例（16名男性和11名女性）与紫杉醇和/或顺铂引起的神经病变（根据世界卫生组织的建议，急性和亚急性毒性作用的分级）被招募。患者接受至少一种顺铂（n = 5）或一种紫杉醇（n = 11）为基础的方案，或两者的组合（n = 11）。化疗引起的周围神经病变的患者与乙酰-L-肉毒碱1克/模具静脉输注超过1-2小时，至少10 days.Results：26例患者进行了评价，已完成至少10天的乙酰-L-肉毒碱治疗（中位数，14天，范围，10-20）的反应。73%的患者显示周围神经病变严重程度至少有一个WHO等级改善。1例患者报告了与ALC治疗相关的失眠病例。乙酰-L-肉毒碱似乎是一种有效的和耐受性良好的药物，用于治疗化疗引起的周围neuropathy.Conclusions：我们的初步结果应在双盲，安慰剂对照研究中得到证实。
Aims and background: In addition to bone marrow suppression and renal toxicity, neurotoxicity is a commonly occurring side effect of widely used chemotherapeutic agents like taxanes, cisplatin and vinca alkaloids. Neurotoxicity can cause antitumor therapy discontinuation or dose regimen modification. The aim of the present exploratory study was to investigate the activity of acetyl-L-carnitine in reversing peripheral neuropathy in patients with chemotherapy-induced peripheral neuropathy.Methods and study design: Twenty-seven patients (16 males and 11 females) with paclitaxel and/or cisplatin-induced neuropathy (according to WHO recommendations for the grading of acute and subacute toxic effects) were enrolled. Patients received at least one cisplatin- (n = 5) or one paclitaxel- (n = 11) based regimen, or a combination of both (n = 11). Patients with chemotherapy-induced peripheral neuropathy were treated with acetyl-L-carnitine 1 g/die iv infusion over 1-2 h for at least 10 days.Results: Twenty-six patients were evaluated for response having completed at least 10 days of acetyl-L-carnitine therapy (median, 14 days; range, 10-20). At least one WHO grade improvement in the peripheral neuropathy severity was shown in 73% of the patients. A case of insomnia related to ALC treatment was reported in one patient. Acetyl-L-carnitine seems to be an effective and well-tolerated agent for the treatment of chemotherapy-induced peripheral neuropathy.Conclusions: Our preliminary results should be confirmed in double-blind, placebo controlled studies.