Paclitaxel, as a third-generation chemotherapy drug, is a landmark tumor chemotherapy drug. It has dealt with many cancer cells, and its efficacy has been verified by long-term clinical practice.

For example, it can be used for the first-line and follow-up treatment of advanced ovarian cancer, the first-line treatment of non-small cell lung cancer, and the second-line treatment of AIDS-related Kaposi's sarcoma.

In the chemotherapy of breast cancer, it is used as a cornerstone scheme and can be applied to various types of chemotherapy: lymph node-positive breast cancer, adjuvant therapy after adjuvant chemotherapy combined with standard doxorubicin regimen, metastatic breast cancer, breast cancer recurring within six months of adjuvant chemotherapy, etc.

Adverse reactions

The adverse reactions of using paclitaxel usually include allergic reactions, bone marrow suppression, neurotoxicity, cardiovascular toxicity, joint and muscle pain, gastrointestinal reactions, liver toxicity, hair loss, etc. The unique adverse reaction of the injection is the allergic reaction to the excipient polyoxyethyl castor oil.

It is a highly lipophilic substance, so when using the injection, polyoxyethyl castor oil and anhydrous ethanol need to be added to assist dissolution. However, polyoxyethyl castor oil can cause allergic reactions of varying degrees, aggravate its peripheral neurotoxicity, and affect the diffusion of drug molecules into tissues, affecting the anti-tumor effect.

In order to prevent the occurrence of allergic reactions, 20 mg of dexamethasone can be taken orally 12 hours and 6 hours before treatment, 50 mg of diphenhydramine can be given intramuscularly 30 to 60 minutes before treatment, and 300 mg of cimetidine or 50 mg of ranitidine can be given intravenously.

Precautions

There are many precautions when using paclitaxel:

1. You must pay attention when preparing it, and it is advisable to wear gloves. If it comes into contact with the skin, wash the skin thoroughly with soap immediately, and once it comes into contact with the mucous membrane, wash it thoroughly with water.

2. During intravenous injection, if the drug solution leaks out of the blood vessel, the injection should be stopped immediately, and local cold compresses and 1% procaine should be used for local sealing.

3. Within 1 hour after the start of the infusion, measure blood pressure, heart rate and respiratory rate every 15 minutes, and pay attention to allergic reactions.

4. Non-PVC infusion bottles and infusion sets should be used for dripping, and the microporous membrane of the filter should be less than 0.22 microns through the connected filter.

5. Paclitaxel concentrated injection must be diluted before intravenous drip. It can be diluted with normal saline, 5% glucose or 5% glucose normal saline, and the final dilution concentration is 0.3~1.2mg/ml.

Since its advent, it has been clinically studied and applied for more than 20 years, and has played its value in the treatment of various tumors. It also plays an important role in breast cancer chemotherapy and is widely used in multiple stages such as neoadjuvant, adjuvant and advanced treatment of breast cancer. Not only is the single drug effective, but it is also often used in combination with other chemotherapy and/or targeted drugs.