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首页> 外文期刊>Journal of oncology pharmacy practice: official publication of the International Society of Oncology Pharmacy Practitioners >Dexamethasone premedication for prophylaxis of taxane toxicities: can the doses be reduced when paclitaxel or docetaxel are given weekly?
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Dexamethasone premedication for prophylaxis of taxane toxicities: can the doses be reduced when paclitaxel or docetaxel are given weekly?

机译：地塞米松预防紫杉烷毒性的前药：每周服用紫杉醇或多西紫杉醇可以降低剂量吗？

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To evaluate the clinical literature supporting reduced doses of dexamethasone to prevent taxane hypersensitivity reactions (HSRs), and edema/skin toxicities in respect to docetaxel, when taxanes are given weekly, as opposed to every 3 weeks.Clinical literature of human-controlled clinical trials, accessed through MEDLINE and meeting abstract databases (from 1990 to 2010).The retrieved literature was reviewed to include all human clinical trials that recorded adverse effect information with weekly taxanes utilizing reduced-dose or tapering dexamethasone schemas, either prospectively or retrospectively.Prophylaxis for paclitaxel-related HSRs generally includes one or more 20 mg doses of dexamethasone, with histamine-1 and -2 receptor antagonists prior to infusion of paclitaxel. Prophylaxis for docetaxel-related HSRs generally includes dexamethasone beginning 1 day before docetaxel, and continuing twice daily for a total of 3 days. These schedules were designed for taxanes given every 3 weeks, but may lead to steroid-related adverse effects when given weekly with weekly taxane administration. Treatment strategies designed to reduce corticosteroid exposure in patients receiving weekly taxanes have been investigated.Several predication strategies utilizing reduced doses of dexamethasone with weekly taxanes appear to be feasible and safe, and can be considered for patients experiencing, or at high risk for steroid-induced side effects. However, the optimal schedule is not yet determined; larger prospective clinical trials are needed.
机译：评估每周减少使用紫杉烷的剂量（而非每3周一次）以支持减少地塞米松剂量以预防紫杉烷超敏反应（HSR）和对多西紫杉醇引起的水肿/皮肤毒性的临床文献。 （1990年至2010年），可通过MEDLINE访问并检索摘要数据库，并对检索到的文献进行回顾，以纳入所有人类临床试验，这些试验均采用前瞻性或回顾性的剂量减少或锥形地塞米松方案每周记录紫杉烷类药物的不良反应信息。紫杉醇相关的HSR通常在输注紫杉醇之前包括一剂或多于20 mg剂量的地塞米松，以及组胺-1和-2受体拮抗剂。多西紫杉醇相关的HSR的预防通常包括在多西紫杉醇使用前1天开始的地塞米松，每天持续两次，共3天。这些时间表是针对每三周施用一次紫杉烷类药物而设计的，但如果每周一次施用紫杉烷类药物，则可能导致类固醇相关的不良反应。已经研究了旨在减少每周紫杉烷类患者皮质类固醇暴露的治疗策略，采用减少剂量地塞米松和每周紫杉烷类药物的几种预防策略似乎是可行和安全的，可以考虑到正在经历或因类固醇诱发的高风险患者副作用。但是，最佳时间表尚未确定。需要进行更大的前瞻性临床试验。

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