铂类药物是目前临床应用最广泛的抗肿瘤药物类别之一，但因存在不同类型和程度的不良反应，故预防和降低不良反应的发生对提高患者的生活质量和减少额外的治疗费用具有重要意义。本文综述铂类药物的各种不良反应的发生机制及其防治方法，以期为使用铂类药物进行个体化治疗提供参考。

Platinum compounds is one of the most widely used anti-tumor drugs for many types of malignant tumors. However, in view of different types and levels of adverse reactions, it is vital to prevent and reduce the occurrence of these adverse reactions so as to improve the quality of life and lower the extra cost of their treatment. The mechanism, prevention and treatment of various platinum-associated adverse reactions are reviewed so that a certain guide can be provided for the individualization of platinum-based therapy.

洛铂是第3代铂类抗肿瘤药物,已上市用于临床治疗晚期乳腺癌、小细胞肺癌和慢性粒细胞白血病.研究表明洛铂作为最新的第3代铂类抗肿瘤药物,具有水溶性好,抗瘤谱广、抗瘤活性强,与其他铂类药物无交叉耐药性及不良反应低诸多特点,已经显示出明显的优势.

Lobaplatin is the third generation platinum anticancer drug,and has been listed for the clinical treatment of advanced breast cancer,small cell lung cancer and chronic myeloid leukemia.Studies have shown that lobaplatin as the latest third generation platinum anticancer drug,has good water solubility,broadspectrum anti-tumor,strong anti-tumor activity,no cross-resistance with other platinum drugs,low toxicity and many other features.Lobaplatin has shown a clear advantage.

曲贝替定(YondelisR,Trabectedin)是一种新的非铂类抗肿瘤药物,有独特的抗肿瘤机制,不良反应主要为可逆性肝脏损害。Trabectedin的心脏毒性低,可以和蒽环类抗肿瘤药物联合应用,目前已应用于复发性卵巢癌的治疗。临床可选用的治疗方案有单药3周方案、单药周疗和联合蒽环类药物方案,其中联合方案疗效最好。Trabectedin对铂类敏感的复发性卵巢癌有较好的疗效,特别是对无铂间隔期(treatment-free interval,TFI)为6~12个月的复发性卵巢癌疗效显著,但对铂类耐药及难治性卵巢癌的疗效不明显。应用Trabectedin可延长TFI,为以后再次进行铂类药物治疗创造条件。

Trabectedin (Yondelis R ) is a new non-platinum antineoplastic drug with a unique antitumor mechanism. It′s main side effect is the reversible liver injury, and it′s cardiac toxicity is low. Trabectedin can be applied with anthracycline-based drugs in the treatment of recurrent ovarian cancer. The optional treatment clinically include:single drug 3 weeks plan, single drug weekly therapy,combined anthracycline-based drugs,the best effect is the in combinational scheme. Trabectedin make satisfied curative effect in platinum sensitive recurrent ovarian cancer ,especially treatment-free interval (TFI) 6-12 month. The platinum resistance and refractory ovarian cancer curative effect is not obvious. Application of Trabectedin can extend the TFI ,as to create conditions for using platinum drugs again.

目的观察不同铂类药物敏感性宫颈癌细胞中的microRNA(miR)-181a表达,提高宫颈癌的药物治疗效果。方法观察不同铂类药物敏感性人体标本与人宫颈鳞状癌细胞系中的miR-181a表达。通过聚合酶链式反应(PCR)与基因转染技术,在体内与体外试验中,对miR-181a表达与铂类药物的敏感性进行研究。结果在2株人宫颈鳞状癌细胞系与人体标本中对化学治疗(简称化疗)药物有耐受性的肿瘤细胞miR-181a高表达,在裸鼠移植瘤模型与经过转染的细胞系中miR-181a的过表达显著增强了化疗的耐药性,而转染了miR-181a抑制因子后,药物敏感性明显升高。结论 miR-181a在调控肿瘤细胞化疗耐药性中有重要的协调作用,研究为预测人宫颈鳞状细胞癌的化疗耐药性提供了一种基因标志物。

Objective To observe the expression of miR - 181a in the cervical cancer cells with different sensitivity to platinum drugs and to improve the effect of medication on cervical cancer. Methods The miR - 181a expression in human specimens and human cer-vical squamous carcinoma cell lines was observed. By using polymerase chain reaction(PCR) and the gene transfection technique, the study on miR - 181a expression and the platinum drugs sensitivity was conducted in the in vivo and in vitro experiments. Results In two strains of human cervical squamous carcinoma cell lines and human specimens, the tumor cell miR - 181a with tolerance to chemotherapy drugs was highly expressed. In the nude mice transplanted tumor model and transfected cell lines, the over expression of miR - 181a significantly enhanced the tolerance to chemotherapy, while after transfecting miR - 181a inhibitory factor, the drug sensitivity was increased significantly. Conclusion MiR - 181a has an important coordinating role

目的探讨Ⅱ~Ⅲ期非小细胞肺癌（NSCLC）患者肿瘤组织中MMP-3和TIMP-3的表达与术后接受含铂药物辅助化疗疗效的相关性。方法应用免疫组化方法检测112例NSCLC患者术后肿瘤组织中MMP-3和TIMP-3的表达，分析与化疗疗效和患者生存资料间的关系。结果患者肿瘤组织中MMP-3阳性率为56.25%，TIMP-3阳性率为47.32%，MMP-3阴性者术后生存优于阳性者；TIMP-3阴性者的术后生存低于阳性者（均P＜0.01)。MMP-3阴性同时TIMP-3阳性的患者术后使用铂类药物辅助化疗，生存时间可能延长。结论 MMP-3和TIMP-3的表达可能作为NSCLC患者术后铂类药物化疗疗效及预后预测的参考指标。

Objective To investigate the expression of MMP- 3, TIMP- 3 in patients with non- smal cel lung cancer (NSCLC) and its relation to the prognosis after chemotherapy. Methods Expression of MMP- 3 and TIMP- 3 in 112 paraffin- em-bedded pathological specimens of NSCLC were determined by immunohistochemistry method. Al patients received plat-inum- based adjuvant chemotherapy after operation. The association of MMP- 3 and TIMP- 3 expression with response to chemotherapy and survival of patients were analyzed. Results Positive expression rates of MMP- 3 and TIMP- 3 were 56.25%and 47.32%in NSCLC patients, respectively. The survival time in MMP- 3 negative group was longer than that in MMP- 3 positive group(P<0.01) and in TIMP- 3 negative group was shorter than that in TIMP- 3 positive group(P<0.01). Patients with negative ex-pression of MMP- 3 and positive expression of TIMP- 3 showed a trend of improved survival time under platinum- based adjuvant chemotherapy. Conclusion The expression of MMP