Abstract：
Ifosfamide is one of the chemotherapy regimens which potentially causes neurotoxicity in patients up to 30%. Aprepitant is administered as an anti-emetic agent in chemotherapy and regarding the inhibitory effect on CYP3A4, aprepitant can increase the risk of ifosfamide adverse effects. This study aims to systematically investigate the relation of ifosfamide-induced neurotoxicity and aprepitant or fosaprepitant in chemotherapy cancer patients. Four databases including PubMed, Scopus, Web of Science, and Embase were systematically reviewed without language restriction and hand searching was performed until December 2021. Total 1639 publications were retrieved and nine studies fulfilled the eligibility criteria. For quality assessment, we used Newcastle-Ottawa quality assessment scales (NOS) for retrospective cohort studies and Cochrane Collaboration tool to assess the risk of bias for a randomized controlled trial. Overall, the results of our systematic review indicated a positive enhanced trend between neurotoxicity and concomitant use of ifosfamide and aprepitant or fosaprepitant, but the association was not statistically significant. As indicated by our findings, several studies identified low albumin as a risk factor for ifosfamide-induced encephalopathy. However, further clinical studies with a larger population of patients are required to evaluate the clinical significance of ifosfamide-related neurotoxicity and aprepitant or fosaprepitant.
摘要：
异环磷酰胺是可能导致高达30%的患者神经毒性的化疗方案之一。阿瑞吡坦在化疗中作为止吐剂给药，关于对CYP3A4的抑制作用，阿瑞吡坦可增加异环磷酰胺不良反应的风险。本研究旨在系统地研究异环磷酰胺诱导的神经毒性与阿瑞吡坦或福沙吡坦在化疗癌症患者中的关系。包括PubMed在内的四个数据库，Scopus,WebofScience,和Embase在没有语言限制的情况下进行了系统审查，并进行了手工搜索，直到2021年12月。共检索到1639份出版物，9项研究符合资格标准。对于质量评估，我们使用纽卡斯尔-渥太华质量评估量表(NOS)进行回顾性队列研究,并使用Cochrane协作工具评估一项随机对照试验的偏倚风险.总的来说,我们的系统评价结果表明神经毒性和同时使用异环磷酰胺和阿瑞匹坦或福沙吡坦之间的积极增强趋势，但相关性无统计学意义.正如我们的发现所表明的，多项研究确定低白蛋白是异环磷酰胺诱发脑病的危险因素.然而,需要对更多患者进行进一步的临床研究,以评估异环磷酰胺相关神经毒性和阿瑞吡坦或福沙吡坦的临床意义.
