Lavoie Smith Ellen M, Cohen Jeffrey A, Pett Marjorie A, Beck Susan L
School of Nursing, University of Michigan, Ann Arbor, USA.
Oncol Nurs Forum. 2011 Mar;38(2):133-42. doi: 10.1188/11.ONF.133-142.
PURPOSE/OBJECTIVES: To assess the validity of neuropathy and neuropathic pain-measurement approaches.
Cross-sectional measurement study.
Two comprehensive cancer centers in the northeastern United States.
117 patients with cancer in an outpatient setting.
Participants were assessed using the five-component Total Neuropathy Score-reduced (TNSr), the TNSr short form (TNSr-SF), individual TNSr items, the Neuropathic Pain Scale for chemotherapy-induced neuropathy (NPS-CIN), and the National Cancer Institute's Common Toxicity Criteria™, version 3.0 (NCI-CTC).
Neuropathy and pain measure scores, cumulative and per M2 chemotherapy dosage, comorbid risk factors, drug class, and the number of neurotoxic drugs received.
TNSr, TNSr-SF, and tendon reflex scores were greater in patients receiving higher cumulative (z range = -2.2 to -3.6; p range = 0.01 to < 0.001) and per M2 (z range = -1.8 to -2.4; p range = 0.04 to < 0.001) chemotherapy doses. Scores from most neuropathy and pain measures were higher in patients with comorbid illnesses (z range = -1.79 to -3.51; p range = 0.03 to < 0.001). Sensory NCI-CTC scores were higher in patients receiving higher cumulative chemotherapy dosage (z = -2.1; p = 0.02). Only the sensory NCI-CTC correlated with other measures (r range = 0.22-0.63; p range = 0.05 to < 0.001).
Findings support the validity of the TNSr, TNSr-SF, tendon reflex item, NPS-CIN, and NCI-CTC sensory grading scale when measuring taxane and platinum-induced neuropathy. However, additional validity testing is warranted.
Comprehensive neuropathy and pain measures mainly used by researchers and neurologists were simplified to more clinically useful tools for use by nurses when monitoring chemotherapy-induced peripheral neuropathy.
目的/目标：评估神经病变及神经性疼痛测量方法的有效性。
横断面测量研究。
美国东北部的两家综合癌症中心。
117名门诊癌症患者。
使用五分量简化总神经病变评分（TNSr）、TNSr简表（TNSr-SF）、TNSr各单项、化疗所致神经病变的神经性疼痛量表（NPS-CIN）以及美国国立癌症研究所的《通用毒性标准》第3.0版（NCI-CTC）对参与者进行评估。
神经病变和疼痛测量分数、累积及每平方米化疗剂量、合并症风险因素、药物类别以及所接受神经毒性药物的数量。
接受更高累积（z范围=-2.2至-3.6；p范围=0.01至<0.001）及每平方米（z范围=-1.8至-2.4；p范围=0.04至<0.001）化疗剂量的患者，其TNSr、TNSr-SF及腱反射分数更高。合并症患者的大多数神经病变和疼痛测量分数更高（z范围=-1.79至-3.51；p范围=0.03至<0.001）。接受更高累积化疗剂量的患者，其NCI-CTC感觉评分更高（z=-2.1；p=0.02）。仅NCI-CTC感觉评分与其他测量方法相关（r范围=0.22 - 0.63；p范围=0.05至<0.001）。
研究结果支持TNSr、TNSr-SF、腱反射单项、NPS-CIN及NCI-CTC感觉分级量表在测量紫杉烷和铂类药物所致神经病变时的有效性。然而，仍需进行额外的有效性测试。
研究人员和神经科医生主要使用的综合神经病变和疼痛测量方法被简化为更具临床实用性的工具，供护士在监测化疗所致周围神经病变时使用。
