Bridges Celia M, Smith Ellen M Lavoie
University of Michigan School of Nursing, 400 N Ingalls St, Ann Arbor, MI, 48109, USA,
Support Care Cancer. 2014 Sep;22(9):2581-92. doi: 10.1007/s00520-014-2317-x. Epub 2014 Jun 21.
In this review, we discuss the plight of Alice, a patient with advanced nonsmall cell lung cancer (NSCLC) who struggles with taxane-related peripheral neuropathy (PN). Using this unique point of view helps us to appreciate the implications of PN on daily activities as well as the difficulty in decision-making regarding continuation of treatment. In addition, published reports of phase 3 trials are reviewed to identify the incidence and severity of chemotherapy-induced PN as well as the assessment tools used in these studies.
A literature review spanning the years 1998-2012 was performed. Phase 3 studies and a meta-analysis of taxane-based therapy in advanced NSCLC were selected for review for their findings regarding the incidence and severity of chemotherapy-induced PN.
In total, 16 phase 3 studies and 1 meta-analysis were reviewed. Use of grading scales and PN assessment tools was inconsistent across the studies, and some studies did not report PN at all.
The true incidence and severity of chemotherapy-induced PN in clinical trials may be masked by nonstandardized reporting; thus, a more standardized approach to grading, assessing, and reporting PN in clinical trials is greatly needed to allow for appropriate comparisons across studies. Understanding chemotherapy-induced PN from the patient's perspective as well as the development of PN at the clinical trial level will help health care providers anticipate the development of PN and improve their ability to manage it.
在本综述中，我们讨论了晚期非小细胞肺癌（NSCLC）患者爱丽丝的困境，她患有紫杉烷相关的周围神经病变（PN）。从这一独特视角出发，有助于我们理解PN对日常活动的影响以及在决定是否继续治疗时所面临的困难。此外，我们还回顾了已发表的3期试验报告，以确定化疗引起的PN的发生率和严重程度，以及这些研究中使用的评估工具。
进行了一项涵盖1998年至2012年的文献综述。选择了3期研究以及晚期NSCLC中基于紫杉烷治疗的荟萃分析，以回顾其关于化疗引起的PN的发生率和严重程度的研究结果。
总共回顾了16项3期研究和1项荟萃分析。各研究中分级量表和PN评估工具的使用并不一致，一些研究根本未报告PN。
临床试验中化疗引起的PN的真实发生率和严重程度可能因报告不规范而被掩盖；因此，迫切需要一种更标准化的方法来对临床试验中的PN进行分级、评估和报告，以便在各项研究之间进行适当比较。从患者角度理解化疗引起的PN以及在临床试验层面了解PN的发展情况，将有助于医疗保健提供者预测PN的发生并提高管理PN的能力。
