爸爸走了，

共创奇迹

今天爸爸的状态更不好了，电话里听着有气无力的。精神很不好，连床都不想起，气功就没法练了。估计血象在进一步下降，这还没到低谷呢。然后是身上无力酸痛，连脚趾都疼，昨天晚上还起来用了退热拴止疼。爸爸对于化疗的副作用承受能力真的很差，这还是第一个疗程呢，不敢想象下面会多么难受。

骨扫描早就预约了，要等20多天，9月15日才能做。

[ 本帖最后由 共创奇迹 于 2009-9-6 18:55 编辑 ]

平衡行走

嗨，我妈妈最近服用了易瑞沙好多了，谢谢你对我之前的回复~~

祝福你爸爸能闯过这关，另外化疗还是不要间隔太短时间就化吧，先踏踏实实把这次的化疗所伤害的气血补回来。说实话我也在考虑耐药之后，老妈如果做化疗的话，希望现在也是让她能够多补点把身体调整好！

共创奇迹

原帖由 平衡行走 于 2009-9-7 13:03 发表
嗨，我妈妈最近服用了易瑞沙好多了，谢谢你对我之前的回复~~

祝福你爸爸能闯过这关，另外化疗还是不要间隔太短时间就化吧，先踏踏实实把这次的化疗所伤害的气血补回来。说实话我也在考虑耐药之后，老妈如果做化疗 ...

呵呵，不用客气，大家共同努力。化疗按规定是21天一次，这应该是根据肿瘤的生长周期来的。如果到时候血象正常的话，我们就按规定化完两次。否则的话就推迟一点。对啊，你们现在要抓紧补身体，同时可以适当锻炼。

共创奇迹

今天爸爸的精神好了点。去医院查血，白细胞只有2900。开了重组人粒细胞核红细胞生成素来打，下周一再查血。如果学像正常的话下下周开始第二次化疗。

共创奇迹

今天精神和昨天差不多。最令人难受的还是神经毒性（神经毒性：周围神经病变发生率为62%，最常见的表现为轻度麻木和感觉异常，严重的神经毒性发生率为6%。）导致的四肢远端，即膝盖和腕部以下的疼痛，不仅是肌肉还有骨头，看是我们是属于严重的神经毒性。每天晚上都要用退热拴才能睡好。

气功是根本没法练了，连出门都勉强。如果有效这苦还值得，如果效果不佳的话真是得不偿失，不知道要多久才能把身体调整过来。我想这次到20天的样子去查个CEA然后决定下面怎么做，但是爸爸说还是坚持把两次都化完。不过也是，要不医院又认为我们是问题份子了。

步行者

神经毒性这么厉害啊
确实很痛苦

共创奇迹

原帖由 步行者 于 2009-9-8 21:54 发表
神经毒性这么厉害啊
确实很痛苦

我刚查了一下，发现爸爸说的还不是神经毒性引起的，而是关节疼和肌痛，泰素的另外一个副作用。上面说用药两三天出现，几天后会好，希望爸爸能尽快好起来。外周神经毒性的症状应该是手脚麻木。

The following Taxol side effects are common (occurring in greater than 30%) for patients taking Taxol:

    * Low blood counts.  Your white and red blood cells and platelets may temporarily decrease.  This can put you at increased risk for infection, anemia and/or bleeding.
    * Hair loss
    * Arthralgias and myalgias （关节疼和肌痛）, pain in the joints and muscles. Usually temporary occurring 2 to 3 days after Taxol, and resolve within a few days.  
    * Peripheral neuropathy 外周神经(numbness and tingling of the hands and feet)
    * Nausea and vomiting (usually mild)
    * Diarrhea
    * Mouth sores
    * Hypersensitivity reaction - fever, facial flushing, chills, shortness of breath, or hives after Taxol is given.  The majority of these reactions occur within the first 10 minutes of an infusion.  Notify your healthcare provider immediately (premedication regimen has significantly decreased the incidence of this reaction).  

The following are less common side effects (occurring in 10-29%) for patients receiving Taxol:

    * Swelling of the feet or ankles (edema).
    * Increases in blood tests measuring liver function.  These return to normal once treatment is discontinued. (see liver problems).
    * Low blood pressure (occurring during the first 3 hours of infusion).
    * Darkening of the skin where previous radiation treatment has been given (radiation recall - see skin reactions).
    * Nail changes (discoloration of nail beds - rare) (see skin reactions).

    Nadir （血象低谷）:  15-21 days 跟中国这边说的不一样，这边说是用药8天后

This list includes common and less common side effects for individuals taking Taxol.  Side effects that are very rare, occurring in less than 10% of patients, are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

# Aching joints (arthralgia) and muscles (myalgia) affects about 6 out of 10 people (60%) - it may start a couple of days after treatment and last for about 5 days   这个说是关节疼和肌痛大概60%的病人都会有，还挺高。大约持续5天

Taxol Self Care Tips:

    * Taxol, or the medications that you take with Taxol may cause you to feel dizzy or drowsy. Do not operate any heavy machinery until you know how you respond to Taxol.
    * If you notice any redness or pain at the injection site, place a warm compress, and notify your healthcare provider.
    * Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
    * You may be at risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of infection immediately to your health care provider.
    * Wash your hands often.
    * To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
    * Use an electric razor and a soft toothbrush to minimize bleeding.
    * Avoid contact sports or activities that could cause injury.
    * Taxol causes little nausea.  But if you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals.  Sucking on lozenges and chewing gum may also help.
    * Acetaminophen or ibuprophen may help relieve discomfort from fever, headache and/or generalized aches and pains.  However, be sure to talk with your doctor before taking it.
    * You may experience drowsiness or dizziness; avoid driving or engaging in tasks that require alertness until your response to the drug is known.
    * Taxol will make you sensitive to sunlight. You must wear sunglasses when outside, and avoid sun exposure. Wear protective clothing, and also wear SPF 15 (or higher) sun block.
    * In general, drinking alcoholic beverages should be kept to a minimum or avoided completely.  You should discuss this with your doctor.
    * Get plenty of rest.
    * Maintain good nutrition.
    * If you experience symptoms or side effects, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

reference: http://www.chemocare.com/bio/taxol.asp

[ 本帖最后由 共创奇迹 于 2009-9-8 23:33 编辑 ]

共创奇迹

刚刚又有一个不好的发现，发现卡铂是烷化剂 （Carboplatin is classified as an "alkylating agent."）.记起前不久看到说这类化疗药可能引起间质性肺炎。回去看了看果真如此。哎，我们化疗前说了要用对肺影响小一点的药，看来没被采纳。本来李医生建议单药化疗，用对肺刺激小的药。到湖肿非要给我们联合化疗，还用的是烷化剂。只有希望不是所有的烷化剂都可能引起间质性肺炎。

据报道有19种化疗药物可引起该损害，这包括烷化剂如环磷酰胺、米尔法兰、瘤可宁、亚硝脲类的Me－CCNU、抗生素类中的博莱霉素（BLM）、丝裂霉素（MMC）。抗代谢药物如氨甲喋呤（MTX）、阿糖胞苷，其他还有 VCR、VDS等，这其中以BLM、亚硝脲类、MMC、MTX更易致肺损害。BLM肺毒性与剂量累积有关，易发生于累积量大于450毫克时，特别当存在危险因素（年龄高于60岁、肺曾接受过放疗、肺慢性炎症与其他诱发肺毒性药物并用等）时。

卡铂也有外周神经毒性，还对中枢神经有毒性。
# Peripheral neuropathy: Although uncommon, a serious side effect of decreased sensation and paresthesia (numbness and tingling of the extremities) may be noted. Sensory loss, numbness and tingling, and difficulty in walking may last for at least as long as therapy is continued. These side effects may become progressively more severe with continued treatment, and your doctor may decide to decrease your dose.
# Central neurotoxicity:  Infrequent but patients over age 65 are at increased risk.  Symptoms include dizziness, confusion, visual changes, ringing in the ears.
烷化剂分类
Alkylating agents are most active in the resting phase of the cell.  These drugs are cell-cycle non-specific.  There are several types of alkylating agents.

    * Mustard gas derivatives:  Mechlorethamine, Cyclophosphamide, Chlorambucil, Melphalan, and Ifosfamide.
    * Ethylenimines:  Thiotepa and Hexamethylmelamine.
    * Alkylsulfonates:  Busulfan.
    * Hydrazines and Triazines:  Procarbazine, Dacarbazine and Temozolomide.
    * Nitrosureas:  Carmustine, Lomustine and Streptozocin.  Nitrosureas are unique because, unlike most chemotherapy, they can cross the blood-brain barrier.  They can be useful in treating brain tumors.
    * Metal salts:  Carboplatin, Cisplatin, and Oxaliplatin.

[ 本帖最后由 共创奇迹 于 2009-9-8 23:57 编辑 ]