Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53, Kawahara-cho, Syogoin, Sakyo-ku, Kyoto City, Kyoto, 606-8507, Japan.
Rehabilitation Unit, Kyoto University Hospital, 54, Kawahara-cyo, Syogoin, Sakyo-ku, Kyoto City, Kyoto, 606-8507, Japan.
Support Care Cancer. 2018 Jul;26(7):2397-2405. doi: 10.1007/s00520-018-4070-z. Epub 2018 Feb 8.
Oxaliplatin, an important chemotherapeutic agent in colorectal cancer, causes chemotherapy-induced peripheral neuropathy (CIPN), for which prophylactic or therapeutic interventions are lacking. We aimed to investigate changes in upper extremities, activities of daily living (ADL), and health-related quality of life (HRQoL) parameters after the first chemotherapy cycle.
Thirty-eight colorectal cancer patients scheduled to receive the leucovorin, 5'-fluorouracil, oxaliplatin (FOLFOX) therapy or the capecitabine, oxaliplatin (CAPOX) therapy, participated. Patients underwent objective assessment of sensory function, muscular strength, and manual dexterity and answered the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and the Disabilities of the Arm, Shoulder, and Hand-Disability/Symptom (DASH-DS) questionnaires for subjective assessment. The CIPN was assessed at baseline and prior to the second drug cycle.
Light touch sensation in both hands worsened significantly after the first drug cycle, though no significant changes were observed in muscular strength and manual dexterity. The QLQ-C30 analysis showed that Physical Functioning, Role Functioning, Nausea and Vomiting, and Dyspnea were significantly worse, whereas Emotional Functioning was improved. The DASH-DS analysis revealed significant worsening of dysfunction and subjective symptoms.
Our results suggest that light touch sensation may worsen even in the absence of multiple chemotherapy cycles. Even if arm and hand function (muscular strength and manual dexterity) is apparently intact, patients may experience dysfunction and decreased HRQoL. For preserving or improving patients' ADL and HRQoL, it is imperative to provide support at chemotherapy initiation.
奥沙利铂是结直肠癌中一种重要的化疗药物，可引起化疗引起的周围神经病（CIPN），但目前缺乏预防或治疗干预措施。我们旨在研究首个化疗周期后上肢、日常生活活动（ADL）和健康相关生活质量（HRQoL）参数的变化。
38 名计划接受亚叶酸钙、5'-氟尿嘧啶、奥沙利铂（FOLFOX）治疗或卡培他滨、奥沙利铂（CAPOX）治疗的结直肠癌患者参与了研究。患者接受了感觉功能、肌肉力量和手灵巧性的客观评估，并回答了欧洲癌症研究与治疗组织生活质量问卷 C30（EORTC QLQ-C30）和手臂、肩部和手部残疾/症状（DASH-DS）问卷，进行主观评估。CIPN 在基线和第二个药物周期前进行评估。
虽然肌肉力量和手灵巧性没有明显变化，但双手的轻触感觉在第一个药物周期后明显恶化。QLQ-C30 分析显示，身体功能、角色功能、恶心和呕吐、呼吸困难明显恶化，而情绪功能得到改善。DASH-DS 分析显示，功能障碍和主观症状明显恶化。
我们的结果表明，即使没有多个化疗周期，轻触感觉也可能恶化。即使手臂和手部功能（肌肉力量和手灵巧性）明显正常，患者也可能出现功能障碍和生活质量下降。为了保持或改善患者的 ADL 和 HRQoL，在化疗开始时提供支持至关重要。
