剂量依赖的神经毒性化疗和角膜神经的形态变化
Jeremy Chung Bo Chiang1, Dimitra Makrynioti2, David Goldstein3
1School of Optometry & Vision Science, University of New South Wales, Sydney, Australia.
Clinical & experimental optometry
|January 22, 2026
概括
早期检测化疗诱导的周围神经病变 (CIPN) 是至关重要的. 通过体内共聚焦显微镜检测到的角膜神经纤维长度变化可以作为癌症治疗期间CIPN进展的早期标志物.
科学领域:
- 眼科医生 眼科 眼科
- 神经学 神经学
- 在瘤学瘤学.
背景情况:
- 化疗诱导的周围神经病变 (CIPN) 是癌症治疗中的一个重要的剂量限制因素.
- CIPN导致神经纤维损伤,难以早期检测,通常在症状出现后被诊断出来.
- 在体内角膜共聚焦显微镜为早期CIPN检测提供了一种潜在的方法.
研究的目的:
- 调查角膜神经的参数是否可以实现早期检测CIPN.
- 评估神经毒性化疗对角膜神经的剂量依赖性影响.
- 在化疗治疗期间和之后纵向监测角膜神经的变化.
主要方法:
- 使用in-vivo激光扫描共聚焦显微镜进行角质神经成像,用于接受基于taxan或oxaliplatin的化疗的患者.
- 在多个时间点进行中央角膜和下神经纤维参数的测量:基线,中期治疗,治疗结束,以及治疗后长达12个月.
- 在患有和没有持续性CIPN.患者之间比较角膜神经参数.
主要成果:
- 随着神经毒性化疗剂量的增加,特别是用税 (p=0.02) 观察到角膜神经的剂量依赖性减少.
- 在治疗过程中早期检测到角膜神经纤维平均长度的显著变化.
- 与没有这种症状的患者相比,患有持续性CIPN的患者的角膜神经纤维长度显著降低,特别是在纳税组 (p=0.02和p=0.006).
结论:
- 平均角膜神经纤维长度损失是监测CIPN进展的潜在早期临床标志物.
- 扫描角膜神经的更广泛区域,包括下,可以提高早期神经病变的检测.
- 角质神经分析显示,早期客观评估化疗引起的神经损伤是有前途的.
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