Department of Pain Treatment, University Hospital, Kyoto Prefectural University of Medicine, Japan.
Anticancer Drugs. 2010 Oct;21(9):877-81. doi: 10.1097/CAD.0b013e32833db89d.
Chemotherapy-induced peripheral neuropathy (CIPN) is a major drug-induced adverse reaction that becomes a dose-limiting toxicity. However, effective strategies for preventing or treating CIPN are lacking. Accordingly, this study aimed to statistically identify predictors for CIPN. Retrospective analysis was carried out for 190 patients who had been treated with bortezomib (n=28), taxanes (paclitaxel or docetaxel; n=58), oxaliplatin (n=52) or vincristine (n=52) at our hospital between April 2005 and December 2008. The severity of CIPN was assessed at the time of chemotherapy completion, graded as grade 0-5 in accordance with the National Cancer Institute Common Terminology Criteria for Adverse Events v3.0. Multivariate ordered logistic regression analysis was used to investigate predictors for CIPN. Predictors for CIPN in patients that were administered bortezomib were no co-administration of dexamethasone [odds ratio (OR), 0.455; confidence interval (CI), 0.208-0.955; P=0.0376] and sex (male) (OR, 3.035; CI, 1.356-6.793; P=0.0069). For taxanes (paclitaxel or docetaxel), the predictor for CIPN was a large number of chemotherapy cycles (OR, 2.379; CI, 1.035-5.466; P=0.0412). For oxaliplatin, the predictors for CIPN were a large number of chemotherapy cycles (OR, 3.089; CI, 1.598-5.972; P=0.0008) and no co-administration of non-steroidal anti-inflammatory drugs (OR, 0.393; CI, 0.197-0.785; P=0.0082). For vincristine, predictors for CIPN were a large number of chemotherapy cycles (OR, 6.015; CI, 1.880-19.248; P=0.0025) and co-administration of an analgesic adjuvant (OR, 3.907; CI, 1.383-11.031; P=0.0101). In conclusion, our study indicates that CIPN will be alleviated by the co-administration of dexamethasone with bortezomib and non-steroidal anti-inflammatory drugs with oxaliplatin.
化疗引起的周围神经病(CIPN)是一种主要的药物引起的不良反应,成为剂量限制毒性。然而,缺乏预防或治疗 CIPN 的有效策略。因此,本研究旨在从统计学角度确定 CIPN 的预测因子。对 2005 年 4 月至 2008 年 12 月在我院接受硼替佐米(n=28)、紫杉烷(紫杉醇或多西他赛;n=58)、奥沙利铂(n=52)或长春新碱(n=52)治疗的 190 例患者进行了回顾性分析。根据国家癌症研究所不良事件通用术语标准 v3.0,在化疗完成时评估 CIPN 的严重程度,分为 0-5 级。采用多变量有序逻辑回归分析探讨 CIPN 的预测因子。接受硼替佐米治疗的患者中,CIPN 的预测因子为同时使用地塞米松(优势比(OR),0.455;置信区间(CI),0.208-0.955;P=0.0376)和男性(OR,3.035;CI,1.356-6.793;P=0.0069)。对于紫杉烷(紫杉醇或多西他赛),CIPN 的预测因子是大量的化疗周期(OR,2.379;CI,1.035-5.466;P=0.0412)。对于奥沙利铂,CIPN 的预测因子是大量的化疗周期(OR,3.089;CI,1.598-5.972;P=0.0008)和未同时使用非甾体抗炎药(OR,0.393;CI,0.197-0.785;P=0.0082)。对于长春新碱,CIPN 的预测因子是大量的化疗周期(OR,6.015;CI,1.880-19.248;P=0.0025)和同时使用镇痛辅助剂(OR,3.907;CI,1.383-11.031;P=0.0101)。总之,我们的研究表明,地塞米松与硼替佐米联合使用,非甾体抗炎药与奥沙利铂联合使用将减轻 CIPN。