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Δ510515、、。、、、。S853.7A1005－1678201504－0185－04E-mailry_0708@163.comE-mailyechsh2006@126.com。Ｒeviewontaxanes-inducedperipheralneuropathyCHENＲuiYAOGuang-yuCHENLu-jiaHUXiao-leiYEChang-shengΔDepartmentofBreastSurgeryNanfangHospitalSouthernMedicalUniversityGuangzhou510515ChinaAbstractAsatubulinstabilizertaxanesarewidelyusedinthetreatmentofbreastcancerovariancancernon-small-celllungcancerNSCLCandpartofheadandneckmalignanttumorsandwereconfirmedtobesignificantlyeffective.Howevertaxanes-inducedperipheralneuropathyTIPNstillaffectsthequalityoflifeandpsychologicalstatusofpatientstovaryingdegreesseverecasescanleadtodosereductionandevenchemotherapyinterruption.InthispaperwesummarizethepathogenesisriskfactorsclinicalassessmenttheprogressofpreventionandtreatmentofTIPNtoprovidethebasisforthepredictionandearlypreventionofTIPNintheclinicaladministrationthuswecanimprovepatients’qualityoflifewhileextendingtheirsurvival．Keywordstaxanesperipheralneuropathypreventionandtreatmentβ-G2M1。、。、、、。taxanesinducedperipheralneurotoxicityTIPN。1TIPNTIPNdorsalrootgangliaDＲGCavaletti1、、、、DＲG2Theiss34DＲGDＲG。TIPN5。6。Flatter7mPTP7。2TIPN、、、。59%～87%—581—201543511%～64%8～10TIPN、、、。。DavidＲCT11。2.1Winer12250mg/m23433%210mg/m23419%175mg/m27%。Lee13250mg/m233-420%-35%≤200mg/m233-45%-12%13。＞170mg/m22-3d6d1＞250mg/m215。Lee133-410%Hilkens16600mg/m2154。Lhermitte17。2.2Smith18ＲCT243。2.3Sahenk19175mg/m2380mg/m23-4。33-420。TIPN。3TIPN、、-、。、。21。22。13。4323－24。。10597±296mg/m2150mg/m256400±205mg/m275-100mg/m23530±319mg/m2962±437mg/m264%14%25。5SNPs、。CYP2C8CYP3A4CYP3A5ABCB126。HertzCYP2C8*327。Sissung282008ATPABCB1Ser893AlaSer893ThrSNPG/T、G/AT/TG/G201029－302006ABCB1312009Chang32DNAFANCD2CIPN33。。TIPN。6TIPN。、E。、、、5-SSＲI。、TIPN。。Ｒao2007ＲCTN00C32700mg/d634。2008ＲCTN01C3300mg/d1035。—681—2015435。5-SNＲIsEllenＲCT30mg/2-560mg/59%38%36。ALCⅡ37。Bianchi3860%79%2。Hershman39409208ALC3000mg/20112ALC24ALC。、E。1874041－42。、、。ⅡE19%63%E43。ⅢE44。TIPN。、、。7TIPN、、。TIPN、、、TIPN。。1ＲowinskyEKDonehowerＲC.PaclitaxeltaxolJ．NEnglJMed1995332151004-1014．2CavalettiGCavallettiEOggioniNetal.DistributionofpaclitaxelwithinthenervoussystemoftheratafterrepeatedintravenousadministrationJ．Neurotoxicology2000213389-394．3TheissCMellerK.TaxolimpairsanterogradeaxonaltransportofmicroinjectedhorseradishperoxidaseindorsalrootganglianeuronsinvitroJ．CellTissueＲes20002992213-224．4ScriptureCDFiggWDSparreboomA.PeripheralneuropathyinducedbypaclitaxelrecentinsightsandfutureperspectivesJ．CurrNeuropharmacol200042165-172．5LaPointeNEMorfiniGBradySTetal.Effectsoferibulinvincristinepaclitaxelandixabepiloneonfastaxonaltransportandkinesin-1drivenmicrotubuleglidingimplicationsforchemotherapy-inducedperipheralneuropathyJ．Neurotoxicology201337231-239．6XiaoWHZhengHBennettGJ.Characterizationofoxaliplatin-inducedchronicpainfulperipheralneuropathyintheratandcomparisonwiththeneuropathyinducedbypaclitaxelJ．Neuroscience201217203194-206．7FlattersSJBennettGJ.Studiesofperipheralsensorynervesinpaclitaxel-inducedpainfulperipheralneuropathyevidenceformitochondrialdysfunctionJ．Pain20061223245-257．8JonesSEErbanJOvermoyerBeta1．ＲandomizedphaseIIIstudyofdocetaxelcomparedwithpaclitaxelinmetastaticbreastcancerJ.JClinOncol20052255425551．9SarosyAGHussainMMSeidenMVeta1．Ten-yearfollow-upofaphase2studyofdose-intensepaclitaxelwithcisplatinandcyclophosphamideasinitialtherapyforpoor-Prognosisadvanced-stageepithelialovariancancerJ.Cancer201011614761484．10NewPZJacksonCEＲinaldiDeta1．PeripheralneuropathysecondarytodocetaxelTaxotere.Neurology199646108111．11DavidKudlowitzFrancoMuggia.DefiningＲisksofTaxaneNeuropathyInsightsfromＲandomizedClinicalTrialJ．ClinCancerＲes201319174570-4577．12WinerEPBerryDAWoolfSetal.Failureofhigher-dosepaclitaxeltoimproveoutcomeinpatientswithmetastaticbreastcancercancerandleukemiagroupBtrial9342J．JClinOncol200422112061-2068．13LeeJJSwainSM.Peripheralneuropathyinducedbymicrotubule-stabilizingagentsJ．JClinOncol200624101633-1642．14PostmaTJVermorkenJBLieftingAJetal.Paclitaxel-inducedneuropathyJ．AnnOncol199565489-494．15FreilichＲJBalmacedaCSeidmanADetal.MotorneuropathyduetodocetaxelandpaclitaxelJ．Neurology1996471115-118．16HilkensPHVerweijJVechtCJetal.ClinicalcharacteristicsofsevereperipheralneuropathyinducedbydocetaxelTaxotereJ．AnnOncol199782187-190．17vandenBentMJHilkensPHSillevisSmittPAetal.Lhermitte’ssignfollowingchemotherapywithdocetaxelJ．Neurology1998502563-564．18SmithＲEBrownAMMamounasEPetal.Ｒandomizedtrialof3-hourversus24-hourinfusionofhigh-dosepaclitaxelinpatientswithmetastaticorlocallyadvancedbreastcancernationalsurgicaladjuvantbreastandbowelprojectprotocolB-26J．JClinOncol199917113403-3411．19SahenkZBarohnＲNewPetal.Taxolneuropathy.Electrodiagnosticandsuralnervebiopsyfndings.J．ArchNeurol1994517726-729．—781—201543520MauriDKamposiorasKTsaliLetal.Overallsurvivalbenefitforweeklyvs.three-weeklytaxanesregimensinadvancedbreastcancerameta-analysisJ．CancerTreatＲev201036169-74．21BalayssacDFerrierJDescoeurJetal.Chemotherapy-inducedperipheralneuropathiesfromclinicalrelevancetopreclinicalevidenceJ．ExpertOpinDrugSaf2011103407-417．22ChaudhryVＲowinskyEKSartoriusSEetal.Periph