The Experimental And Clinical Analysis Of Bone Marrow Inhibition Caused By Docetaxel

PURPOSEThis topic mainly design of SD rats received different doses of docetaxel in order toobserve the effects of rat; To observe and evaluate the clinical features and treatmentstrategies of IV myelosuppression which after induction chemotherapy of oral mucosasquamous cell carcinoma under conventional dosage.METHODS:(1) Animal experiment:40SD rats were randomly divided into four groups, givenintraperitoneal injection of different doses of docetaxel by gradient. Observate theweight of rats, mental state, special circumstances, and have complete blood countregular。(2) Case analysis:29patients with oral mucosa squamous cell carcinoma diagnosedpathologically between2006and2012were enrolled into this study. The patientsreceived induction chemotherapy with docetaxel-cisplatin-5-fluorouracil (TPF) andsuffered with grade IV myelosuppression. Regulations and treatment strategies of thebone marrow myelosuppression, were analyzed retrospectively.RESULTS:(1) The experimental group rats, neural state are influenced by docetaxel, body weight,white blood cell count, neutrophil count has generally U type wave, with the increase ofdose, the greater the fluctuations and the data count curve of the control group is almoststraight line. (2) Case analysis:29cases had bone marrow suppression at the time of9-14days afterinduction chemotherapy, and the median time was10days, with a "U"-shape fluctuationpattern. There were26cases of CSF therapy completing treatment according toschedule;2cases were required to the treatment of radiotherapy because of theunsatisfied effect of CSF therapy;1case died and the chemotherapy death rate was0.68%in this group.CONCLUSIONS:(1) Different doses of docetaxel can produce different effects on the general condition ofrats, the representative of the white blood cell and neutrophil of different degree ofinhibition of bone marrow toxicity, and the effect increases with dose increase.(2) The incidence of grade IV myelosuppression was normal and fatal; this studyshowed the starting time of the "U"-shape fluctuation and the necessaries of adding CSFtherapy at the same time. The emergency treatments of myelosuppression should beused including single disinfected ward, mouthninse, the therapy of CSF drug.