School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA.
Schools of Medicine, University of California, San Francisco, CA, USA.
J Cancer Surviv. 2018 Apr;12(2):234-245. doi: 10.1007/s11764-017-0662-8. Epub 2017 Nov 20.
Limited information is available on the impact of chemotherapy (CTX)-induced neurotoxicity on adult survivors' symptom experience and quality of life (QOL). Purposes were to describe occurrence of hearing loss and tinnitus and evaluate for differences in phenotypic characteristics and measures of sensation, balance, perceived stress, symptom burden, and QOL between survivors who received neurotoxic CTX and did (i.e., neurotoxicity group) and did not (i.e., no neurotoxicity group) develop neurotoxicity. Neurotoxicity was defined as the presence of chemotherapy-induced neuropathy (CIN), hearing loss, and tinnitus. Survivors in the no neurotoxicity group had none of these conditions.
Survivors (n = 609) completed questionnaires that evaluated hearing loss, tinnitus, stress, symptoms, and QOL. Objective measures of sensation and balance were evaluated.
Of the 609 survivors evaluated, 68.6% did and 31.4% did not have CIN. Of the survivors without CIN, 42.4% reported either hearing loss and/or tinnitus and 48.1% of the survivors with CIN reported some form of ototoxicity. Compared to the no neurotoxicity group (n = 110), survivors in the neurotoxicity group (n = 85) were older, were less likely to be employed, had a higher comorbidity burden, and a higher symptom burden, higher levels of perceived stress, and poorer QOL (all p < .05).
Findings suggest that CIN, hearing loss, and tinnitus are relatively common conditions in survivors who received neurotoxic CTX.
Survivors need to be evaluated for these neurotoxicities and receive appropriate interventions. Referrals to audiologists and physical therapists are warranted to improve survivors' hearing ability, functional status, and QOL.
关于化疗（CTX）诱导的神经毒性对成年幸存者症状体验和生活质量（QOL）的影响，信息有限。目的是描述听力损失和耳鸣的发生情况，并评估接受神经毒性 CTX 后发生（即神经毒性组）和未发生（即无神经毒性组）神经毒性的幸存者在表型特征和感觉、平衡、感知压力、症状负担以及 QOL 测量方面的差异。神经毒性定义为存在化疗诱导的周围神经病（CIN）、听力损失和耳鸣。无神经毒性组的幸存者没有这些情况。
幸存者（n=609）完成了评估听力损失、耳鸣、压力、症状和 QOL 的问卷。感觉和平衡的客观测量也进行了评估。
在 609 名接受评估的幸存者中，68.6%有 CIN，31.4%没有 CIN。在没有 CIN 的幸存者中，42.4%报告有听力损失和/或耳鸣，48.1%有 CIN 的幸存者报告有某种形式的耳毒性。与无神经毒性组（n=110）相比，神经毒性组（n=85）的幸存者年龄更大，更不可能就业，共病负担更高，症状负担更大，感知压力水平更高，生活质量更差（均 p<.05）。
研究结果表明，CIN、听力损失和耳鸣在接受神经毒性 CTX 的幸存者中是相对常见的情况。
幸存者需要接受这些神经毒性的评估并接受适当的干预。有必要向听力学家和物理治疗师转介，以提高幸存者的听力能力、功能状态和 QOL。
