Fernandes Ricardo, Mazzarello Sasha, Hutton Brian, Shorr Risa, Ibrahim Mohammed F K, Jacobs Carmel, Ong Michael, Clemons Mark
Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, Ontario, Canada.
Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Ontario, Canada.
Clin Genitourin Cancer. 2017 Feb;15(1):1-6. doi: 10.1016/j.clgc.2016.07.018. Epub 2016 Jul 28.
Taxane acute pain syndrome (TAPS) is characterized by myalgia and arthralgia starting 24 to 48 hours after taxane-based chemotherapy and lasting ≤ 7 days. Little is known about its incidence and predisposing factors in patients with prostate cancer. A systematic review was performed to identify studies reporting the incidence and risk factors for TAPS in patients receiving taxane-based chemotherapy for prostate cancer. Embase, Ovid Medline, and other nonindexed citations were searched from 1947 to July 7, 2015. Randomized trials and prospective observational studies reporting the outcomes for prostate cancer patients who had received taxane-based chemotherapy were assessed. Four reviewers independently screened the citations and full text reports for data collection. Of 980 citations, 5 studies (2710 patients) met the eligibility criteria. The incidence of myalgia and arthralgia was reported in 4 trials (14%, [29% and 38%], 44.2%, and 46%). TAPS was not reported with cabazitaxel chemotherapy. Clinical risk factors were identified in 4 studies, suggesting that TAPS was numerically more common in the castrate-resistant setting and when concurrent medications (eg, corticosteroids) were not used. Although the TAPS incidence has been poorly reported in clinical practice, the results of the present study suggest that arthralgia and myalgia are a common toxicity in patients with prostate cancer. An improved and universal definition of TAPS, patient-directed reporting of TAPS, and improved standardized assessments are needed to better identify patients at the greatest risk of experiencing TAPS and improving patient care.
紫杉烷急性疼痛综合征（TAPS）的特征是在基于紫杉烷的化疗后24至48小时开始出现肌痛和关节痛，并持续≤7天。关于前列腺癌患者中其发病率和易感因素知之甚少。进行了一项系统评价，以确定报告接受基于紫杉烷化疗的前列腺癌患者中TAPS发病率和危险因素的研究。检索了1947年至2015年7月7日的Embase、Ovid Medline及其他未索引的文献。对报告接受基于紫杉烷化疗的前列腺癌患者结局的随机试验和前瞻性观察性研究进行了评估。四名审阅者独立筛选文献和全文报告以收集数据。在980篇文献中，5项研究（2710例患者）符合纳入标准。4项试验报告了肌痛和关节痛的发生率（分别为14%、[29%和38%]、44.2%和46%）。卡巴他赛化疗未报告TAPS。4项研究确定了临床危险因素，表明TAPS在去势抵抗性情况下以及未使用同时服用的药物（如皮质类固醇）时在数值上更为常见。虽然临床实践中对TAPS发病率的报告较差，但本研究结果表明关节痛和肌痛是前列腺癌患者常见的毒性反应。需要改进和统一TAPS的定义、患者对TAPS的报告以及改进标准化评估，以更好地识别发生TAPS风险最高的患者并改善患者护理。
