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在一个大型社区肿瘤医疗实践中接受治疗的乳腺癌女性患者中,化疗引起的周围神经病变的患病率及模式。

The prevalence and pattern of chemotherapy-induced peripheral neuropathy among women with breast cancer receiving care in a large community oncology practice.

作者信息

Simon Natalie B, Danso Michael A, Alberico Thomas A, Basch Ethan, Bennett Antonia V

机构信息

College of Arts and Sciences, University of Virginia, 1521 Virginia Ave. Apt. 1, Charlottesville, VA, 22903, USA.

Department of Medical Oncology and Hematology, Virginia Oncology Associates, Norfolk, VA, USA.

出版信息

Qual Life Res. 2017 Oct;26(10):2763-2772. doi: 10.1007/s11136-017-1635-0. Epub 2017 Jun 29.

Abstract

PURPOSE

To describe the prevalence, severity, and risk factors of chemotherapy-induced peripheral neuropathy (CIPN) and its impact on function and quality of life (QOL) among women treated for breast cancer in a large U.S. Community Oncology practice.

METHODS

Women previously treated with taxane-based chemotherapy for early-stage breast cancer completed the EORTC QLQ-C30, QLQ-BR23, and QLQ-CIPN20. Subscales are scored 0-100; higher scores indicate greater symptom severity. Pre-specified hypotheses were tested.

RESULTS

126 women with mean age 56.7 years (SD 11.8) were stage I-II (79.4%) or stage III (20.6%) at the time of the survey; 65.1% were White and 27.8% were Black or African American. The mean time since last taxane chemotherapy cycle was 144.9 weeks (SD 112.9). 73.0% reported having CIPN. QLQ-CIPN20 mean scores for the sensory, motor, and autonomic subscales were 18.9 (SD 23.1), 18.6 (SD 18.7), and 17.1 (SD 21.8), respectively. CIPN symptom severity was negatively correlated with global health status/QOL and physical and role functioning (range of r = -0.46 to -0.72). It was not associated with age, body mass index, diabetes, or cumulative taxane dosage, but was greater for Black or African American women (e.g., sensory, p < 0.002). CIPN sensory impairment was marginally greater for patients treated with paclitaxel compared to docetaxel (p < 0.064).

CONCLUSIONS

CIPN was prevalent in this community oncology practice and significantly impacts function and QOL. These data highlight the importance of developing methods to mitigate CIPN, and for screening for CIPN particularly among Black or African American women.

摘要

目的

描述在美国一个大型社区肿瘤学实践中,接受乳腺癌治疗的女性化疗引起的周围神经病变(CIPN)的患病率、严重程度和危险因素,及其对功能和生活质量(QOL)的影响。

方法

曾接受紫杉烷类化疗治疗早期乳腺癌的女性完成了欧洲癌症研究与治疗组织(EORTC)的QLQ-C30、QLQ-BR23和QLQ-CIPN20问卷。分量表得分范围为0至100分;得分越高表明症状越严重。对预先设定的假设进行了检验。

结果

126名平均年龄为56.7岁(标准差11.8)的女性在调查时处于I-II期(79.4%)或III期(20.6%);65.1%为白人,27.8%为黑人或非裔美国人。自上次紫杉烷化疗周期以来的平均时间为144.9周(标准差112.9)。73.0%的人报告患有CIPN。QLQ-CIPN20感觉、运动和自主神经分量表的平均得分分别为18.9(标准差23.1)、18.6(标准差18.7)和17.1(标准差21.8)。CIPN症状严重程度与总体健康状况/QOL以及身体和角色功能呈负相关(相关系数r范围为-0.46至-0.72)。它与年龄、体重指数、糖尿病或紫杉烷累积剂量无关,但黑人或非裔美国女性的症状更严重(例如,感觉方面,p<0.002)。与多西他赛相比,接受紫杉醇治疗的患者CIPN感觉障碍略更严重(p<0.064)。

结论

CIPN在该社区肿瘤学实践中很普遍,并且对功能和QOL有显著影响。这些数据凸显了开发减轻CIPN方法的重要性,以及筛查CIPN的重要性,特别是在黑人或非裔美国女性中。

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