Kiser Deleslie W, Greer Tara B, Wilmoth Margaret C, Dmochowski Jacek, Naumann R Wendel
Gynecologic Oncology Department, Blumenthal Cancer Center, Charlotte, NC, USA.
Oncol Nurs Forum. 2010 Nov;37(6):758-64. doi: 10.1188/10.ONF.758-764.
PURPOSE/OBJECTIVES: To analyze the incidence of chemotherapy-induced neuropathy in a set of patients with gynecologic cancer who were treated with known neurotoxic agents, to identify correlative factors related to patients' experience of neuropathy, and to analyze providers' assessment and treatment of neuropathy.
Observational descriptive study of patient-reported neuropathy using a retrospective chart analysis.
A hospital-based outpatient infusion center in the southeastern United States.
A convenience sample of 171 patients with gynecologic cancer for a total of 302 chemotherapy treatments.
A mixed model and compound symmetry covariance matrix was used to adjust for correlations between neuropathy treatment scores and patients who completed more than one chemotherapy cycle. Backward elimination method was used to determine the final model.
Functional Assessment of Cancer Treatment/Gynecologic Oncology Group-Neuropathy Treatment scores, patients' demographic information, past medical history, and chemotherapy history.
Patients who were physically shorter and heavier than the average population had the highest rating of neuropathy. Patients who were treated with nontaxane and platinum therapies had less neuropathy than patients who were treated with first-line taxanes and platinums. Neuropathy was noted by providers early in the course of treatment, and providers' grading was consistent with the patients' scoring.
First-line treatments for gynecologic malignancies resulted in the highest neuropathy scores; however, patients who had received previous treatment with taxane and platinum therapies had lower neuropathy scores than patients currently receiving taxanes and platinums, suggesting that neuropathy improved after completion of first-line therapy and that second-line therapies were not necessarily correlative with worsening scores.
Nurses must educate patients about symptoms of neuropathy and the need to report symptoms. Nurses must recognize patients at highest risk for neuropathy and advocate use of validated assessment tools.
目的/目标：分析一组接受已知神经毒性药物治疗的妇科癌症患者中化疗引起的神经病变的发生率，确定与患者神经病变经历相关的相关因素，并分析医护人员对神经病变的评估和治疗。
采用回顾性病历分析对患者报告的神经病变进行观察性描述性研究。
美国东南部一家基于医院的门诊输液中心。
171例妇科癌症患者的便利样本，共进行了302次化疗。
使用混合模型和复合对称协方差矩阵来调整神经病变治疗评分与完成多个化疗周期的患者之间的相关性。采用向后消除法确定最终模型。
癌症治疗功能评估/妇科肿瘤学组-神经病变治疗评分、患者人口统计学信息、既往病史和化疗史。
身材比平均人群更矮更重的患者神经病变评分最高。接受非紫杉烷和铂类疗法治疗的患者比接受一线紫杉烷和铂类疗法治疗的患者神经病变更少。医护人员在治疗早期就注意到了神经病变，且医护人员的分级与患者的评分一致。
妇科恶性肿瘤的一线治疗导致最高的神经病变评分；然而，先前接受过紫杉烷和铂类疗法治疗的患者的神经病变评分低于目前接受紫杉烷和铂类疗法治疗的患者，这表明一线治疗完成后神经病变有所改善，且二线疗法不一定与评分恶化相关。
护士必须对患者进行神经病变症状及报告症状必要性的教育。护士必须识别神经病变风险最高的患者，并提倡使用经过验证的评估工具。
