Department of Oncology, Helsinki University Central Hospital, PO Box 180, 00029 HUS, Helsinki, Finland.
Support Care Cancer. 2011 Dec;19(12):1991-6. doi: 10.1007/s00520-010-1043-2. Epub 2010 Nov 16.
Neuropathy is a common adverse effect of chemotherapy. However, the both the prevalence and the burden of this adverse effect have been poorly documented. The aim of the study was to assess the prevalence and discomfort caused by neuropathic symptoms in relation to other adverse effects of chemotherapy.
Between January 2002 and June 2004, we screened 448 patients who were treated with vinca alkaloids, taxanes or platina derivatives, using a simple questionnaire of neuropathic symptoms. The response rate was 75%. Neuropathic symptoms were reported by 258 respondents (76%), of whom 152 patients were eligible for the final analyses. The severity of neuropathy was scored using the National Cancer Institute Common Toxicity Criteria.
At the screening visit, 90 patients (59%) still reported neuropathic symptoms. Tingling (71%), numbness (58%), impaired sensory function (46%) and pain in hands and feet (40%) were the most common symptoms. The median intensity of neuropathic symptoms was 28/100 on the visual analogue scale. Grade 1 sensory neuropathy was found in 19 out of 90 patients (21%), grade 2 in 38 (42%) and grade 3 in 33 (37%) patients. Grade 1 motor neuropathy was found in 28 (31%), grade 2 in 14 (16%) and grade 3 in one patient (1%). Grade 4 sensory or motor neuropathy was not seen. In the whole cohort of 152 patients, fatigue (66%), mucositis (61%) and neuropathic symptoms (59%) were the most commonly reported symptoms. Every third patient (37%) with neuropathic symptoms ranked them as the most troublesome symptom.
Neuropathy is a common and troublesome adverse effect of chemotherapy, even though the intensity of the symptoms is mild. Thus, the intensity and inconvenience does not correlate to each other.
神经病变是化疗的常见不良反应。然而，这种不良反应的患病率和负担都没有得到很好的记录。本研究的目的是评估与化疗其他不良反应相关的神经病变症状的患病率和引起的不适。
2002 年 1 月至 2004 年 6 月期间，我们使用简单的神经病变症状问卷对接受长春碱类、紫杉烷类或铂类衍生物治疗的 448 例患者进行了筛选。应答率为 75%。258 名应答者（76%）报告有神经病变症状，其中 152 名患者符合最终分析的条件。使用国家癌症研究所常见毒性标准对神经病变的严重程度进行评分。
在筛查就诊时，90 名患者（59%）仍报告有神经病变症状。刺痛（71%）、麻木（58%）、感觉功能受损（46%）和手脚疼痛（40%）是最常见的症状。神经病变症状的中位强度为视觉模拟量表上的 28/100。90 名患者中有 19 名（21%）出现 1 级感觉神经病变，38 名（42%）出现 2 级，33 名（37%）出现 3 级。28 名患者（31%）出现 1 级运动神经病变，14 名（16%）出现 2 级，1 名（1%）出现 3 级。未发现 4 级感觉或运动神经病变。在整个 152 例患者队列中，疲劳（66%）、黏膜炎（61%）和神经病变症状（59%）是最常报告的症状。每 3 例（37%）有神经病变症状的患者将其列为最麻烦的症状。
神经病变是化疗的一种常见且麻烦的不良反应，尽管症状的强度较轻。因此，强度和不便程度并不相互关联。
