EFFECTIVENESS OF ALPHA-LIPOIC ACID AND IPIDACRINE HYDROCHLORIDE IN PREVENTION OF PACLITAXEL-INDUCED PERIPHERAL NEUROPATHY ASSESSED BY ELECTRONEUROMYOGRAPHY OF SUPERFICIAL PERONEAL AND SURAL NERVES.

Q3 Medicine
I S Holotiuk, A Ye Kryzhanivska, S I Holotiuk, V V Holotiuk, S V Maliborska
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引用次数: 1

Abstract

Aim: To investigate the neurofunctional parameters in breast cancer (BC) patients with paclitaxel-induced peripheral neuropathy (PIPN) and to clarify the feasibility of using alpha-lipoic acid (ALA) in combination with the acetylcholinesterase inhibitor ipidacrine hydrochloride (IPD) for its prevention.

Materials and methods: 100 BC patients (T1-4N0-3M0-1) prescribed for polychemotherapy (PCT) by the AT (paclitaxel, doxorubicin) or ET (paclitaxel, epirubicin) regimens in the neoadjuvant, adjuvant or palliative modes, were enrolled. The patients were randomized into two groups (n = 50 per group): group I treated by PCT only; group II treated with PCT plus the studied PIPN prevention scheme (ALA in combination with IPD). An electroneuromyography (ENMG) of the sensory (superficial peroneal and sural) nerves was performed before PCT, and after the 3 and 6 PCT cycles.

Results: According to ENMG data, the electrophysiological disturbances in the sensory nerves were manifested in the form of axonal sensory peripheral neuropathy of a symmetrical nature, which was reflected in a decrease in the amplitude of the action potential (AP) of the studied nerves. The AP reduction in sensory nerves was dominant, in contrast to the nerve conduction velocity, which in most patients remained within the reference values, thus evidencing on axonal degeneration rather than demyelination as an underlying cause of PIPN. The ENMG testing of the sensory nerve in the groups of BC patients treated by PCT with paclitaxel with or without PIPN prevention treatment established that the use of ALA in combination with IPD significantly improved AP amplitude, duration and area of ​​the response to the stimulation of the superficial peroneal and sural nerves after 3 and 6 PCT cycles.

Conclusion: The use of ALA in combination with IPD significantly reduced the severity of damage to the superficial peroneal and sural nerves caused by PCT with paclitaxel and could be recommended for PIPN prevention.

应用腓浅神经和腓肠神经肌电图评价α -硫辛酸和盐酸伊比达克林预防紫杉醇所致周围神经病变的疗效。
目的:探讨乳腺癌(BC)紫杉醇诱导的周围神经病变(PIPN)患者的神经功能参数,阐明α -硫辛酸(ALA)联合乙酰胆碱酯酶抑制剂盐酸ipidacrine (IPD)预防其发生的可行性。材料与方法:入选100例BC患者(T1-4N0-3M0-1),采用AT(紫杉醇、阿霉素)或ET(紫杉醇、表柔比星)方案,采用新辅助、辅助或姑息方式进行多化疗(PCT)。患者随机分为两组(每组50例):一组仅接受PCT治疗;II组采用PCT +所研究的PIPN预防方案(ALA联合IPD)。在PCT前和第3、6个PCT周期后分别行感觉(腓浅神经和腓肠)神经肌电图(ENMG)检查。结果:根据ENMG数据,感觉神经的电生理紊乱表现为对称性轴突感觉周围神经病变,表现为所研究神经的动作电位(AP)幅度下降。感觉神经AP减少占主导地位,而神经传导速度在大多数患者中保持在参考值内,从而证明轴突变性而非脱髓鞘是PIPN的根本原因。经紫杉醇联合PCT治疗或不联合PIPN预防治疗的BC患者的感觉神经ENMG检测证实,ALA联合IPD在3和6个PCT周期后显著改善了腓浅神经和腓肠浅神经刺激的AP幅度、持续时间和反应面积。结论:ALA联合IPD可明显减轻紫杉醇联合PCT对腓浅神经和腓肠浅神经的损伤程度,可推荐用于PIPN预防。
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来源期刊
Experimental oncology
Experimental oncology Medicine-Oncology
CiteScore
1.40
自引率
0.00%
发文量
49
期刊介绍: The Experimental Oncology is an English-language journal that publishes review articles, original contributions, short communications, case reports and technical advances presenting new data in the field of experimental and fundamental oncology. Manuscripts should be written in English, contain original work, which has not been published or submitted for publication elsewhere. It also implies the transfer of the Copyright from the author to “Experimental Oncology”. No part of journal publications may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the prior permission of the publisher.
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