静脉注射大剂量硒预防胃切除术后接受奥沙利铂和卡培他滨辅助治疗的胃癌患者化疗引起的周围神经病变的疗效和安全性:一项回顾性试点研究。

Korean journal of clinical oncology Pub Date : 2025-08-01 Epub Date: 2025-08-31 DOI:10.14216/kjco.25349
Wedyan Alhazmi, Kyo Young Song
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引用次数: 0

摘要

目的:化疗引起的周围神经病变(CIPN)是与奥沙利铂为基础的胃癌患者化疗相关的常见剂量限制性毒性。最近的研究表明,高剂量静脉注射硒可能对接受铂类化疗的患者发挥神经保护作用。方法:这项初步研究分析了2024年1月至12月期间接受胃切除术的III期胃腺癌患者。共纳入28例接受卡培他滨+奥沙利铂(XELOX)辅助化疗的患者,分为两组:一组单独化疗(不含硒:n= 17),另一组化疗前静脉注射硒(2000µg/天)(含硒:n= 11)。在第一个化疗周期后和化疗完成时使用标准化分级标准评估CIPN严重程度。结果:基线临床病理特征,包括年龄、性别、体重指数、术前合并症、切除程度、手术时间和住院时间,组间具有可比性。未观察到与高剂量硒相关的不良事件。化疗相关不良事件,如手足综合征、恶心、呕吐、腹泻和食欲不振,两组间无显著差异。虽然在第一个化疗周期后各组间CIPN严重程度相似,但在化疗结束时,硒组的感觉异常严重程度明显低于非硒组(P < 0.0001)。结论:大剂量静脉注射硒似乎是一种安全且潜在有效的干预措施,可减少奥沙利铂化疗相关的感觉异常。需要进一步的大规模前瞻性研究来验证这些发现并建立最佳给药指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Efficacy and safety of intravenous administration of high-dose selenium for preventing chemotherapy-induced peripheral neuropathy in gastric cancer patients receiving adjuvant oxaliplatin and capecitabine after gastrectomy: a retrospective pilot study.

Efficacy and safety of intravenous administration of high-dose selenium for preventing chemotherapy-induced peripheral neuropathy in gastric cancer patients receiving adjuvant oxaliplatin and capecitabine after gastrectomy: a retrospective pilot study.

Efficacy and safety of intravenous administration of high-dose selenium for preventing chemotherapy-induced peripheral neuropathy in gastric cancer patients receiving adjuvant oxaliplatin and capecitabine after gastrectomy: a retrospective pilot study.

Efficacy and safety of intravenous administration of high-dose selenium for preventing chemotherapy-induced peripheral neuropathy in gastric cancer patients receiving adjuvant oxaliplatin and capecitabine after gastrectomy: a retrospective pilot study.

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting toxicity associated with oxaliplatin-based chemotherapy in gastric cancer patients. Recent studies suggest that high-dose intravenous selenium may exert neuroprotective effects in patients receiving platinum-based chemotherapy.

Methods: This pilot study analyzed patients with stage III gastric adenocarcinoma who underwent gastrectomy between January and December 2024. A total of 28 patients receiving adjuvant capecitabine plus oxaliplatin (XELOX) chemotherapy were included and divided into two groups: one receiving chemotherapy alone (non-selenium: n= 17) and the other receiving an intravenous injection of selenium (2,000 µg/day) before chemotherapy (selenium: n= 11). CIPN severity was assessed after the first chemotherapy cycle and at the completion of chemotherapy using standardized grading criteria.

Results: Baseline clinicopathological characteristics, including age, sex, body mass index, preoperative comorbidities, extent of resection, operation time, and hospital stay, were comparable between groups. No adverse events related to high-dose selenium administration were observed. There were no significant differences in chemotherapy-related adverse events, such as hand-foot syndrome, nausea, vomiting, diarrhea, and loss of appetite, between the two groups. While CIPN severity was similar between groups after the first chemotherapy cycle, by the end of chemotherapy, the selenium group exhibited significantly lower paresthesia severity compared to the non-selenium group (P < 0.0001).

Conclusion: High-dose intravenous selenium appears to be a safe and potentially effective intervention for reducing paresthesia associated with oxaliplatin-based chemotherapy. Further large-scale prospective studies are warranted to validate these findings and establish optimal dosing guidelines.

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