Views:0 Author:Site Editor Publish Time: 2021-11-26 Origin:Site
Paclitaxel is also known as Taxol, Porphyrin, and Tesu. It is a new type of anti-cancer drug that has received great attention and popularity in recent years, especially for the treatment of ovarian cancer and breast cancer. The first-line drugs for the two diseases, if used with cisplatin, can effectively fight lung cancer. Let's take a look at the efficacy and effects of paclitaxel together!
Paclitaxel is mainly suitable for ovarian cancer and breast cancer. It also has certain effects on lung cancer, colorectal cancer, melanoma, head and neck cancer, lymphoma, and brain tumors. Microtubules are a component of eukaryotic cells. Under normal circumstances, there is a dynamic balance between microtubules and tubulin dimers. Paclitaxel can make the dynamic balance between the two lose this dynamic balance and induce and promote tubulin. Polymerization, preventing depolymerization, and stabilizing microtubules. These effects cause cells to fail to form spindles and spindle filaments during mitosis, inhibit cell division and proliferation, thereby exerting anti-tumor effects.
1. Ask the patient if he has a history of allergies, and check the white blood cell and platelet data. People with a history of allergies and those with low white blood cells/platelets should be used with caution.
2. Paclitaxel can cause allergic reactions. Take dexamethasone 20 mg 12 hours and 6 hours before administration, and give diphenhydramine 50 mg orally and cimetidine 300 mg intravenously 30 to 60 minutes before administration.
3. The usual dosage of paclitaxel is 135～175 mg/m2, and the injection should be added to 500～1000 ml of normal saline or 5% glucose solution first. A glass bottle or non-polyethylene infusion set is required, and a special hose is used, and 0.22 micron microporous membrane filtration.
4. Blood pressure, heart rate, and breathing should be measured every 15 minutes after the instillation starts, and pay attention to whether there is any allergic reaction.
5. Paclitaxel is generally instilled for 3 hours.
6. The blood image should be checked at least twice a week after paclitaxel injection, and can be repeated after 3 to 4 weeks as appropriate.
7. Paclitaxel can be used in combination with cisplatin, carboplatin, ifosfamide, fluorouracil, doxorubicin, VP-16, etc. G-CSF should be used when the blood image is low, or paclitaxel and G-CSF can be used for preventive administration.
1. Allergic reaction: the incidence rate is 39%, of which the incidence rate of severe allergic reaction is 2%. Most are type 1 allergies, manifested as bronchospasm, dyspnea, urticaria, and hypotension. Almost all reactions occur within the first 10 minutes after the medication.
2. Bone marrow suppression: It is the main dose-limiting toxicity, manifested as neutropenia, and thrombocytopenia is rare. It usually occurs 8 to 10 days after medication. The incidence of severe neutrophils was 47%, and the incidence of severe thrombocytopenia was 5%. Anemia is more common.
3. Neurotoxicity: The incidence of peripheral neuropathy is 62%, the most common manifestations are mild numbness and paresthesia, and the incidence of severe neurotoxicity is 6%.
4. Cardiovascular toxicity: there may be hypotension and asymptomatic short-term bradycardia. Muscle and joint pain: The incidence is 55%, occurs in the limbs and joints, and the incidence and severity are dose-dependent.
5. Gastrointestinal reactions: the incidence of nausea, vomiting, diarrhea and mucositis were 59%\43% and 39%, and they were generally mild and moderate.
6. Liver toxicity: elevated ALT, AST and AKP.
7. Hair loss: the incidence rate is 80%.
8. Local reaction: Inflammation of the intravenous infusion of the drug and the local inflammation of the drug extravasation.