Department of Neurology, University of Minnesota, Minneapolis, Minnesota.
Department of Neurology, Northwestern University, Chicago, Illinois.
J Peripher Nerv Syst. 2018 Jun;23(2):129-133. doi: 10.1111/jns.12271. Epub 2018 May 11.
Peripheral neuropathy is a common side effect of many chemotherapeutic agents including paclitaxel. We prospectively evaluated demographic and laboratory data in a cohort of 61 woman with breast cancer prior to paclitaxel exposure to explore factors that predispose to neuropathy development. Neuropathy was graded based on the total neuropathy score reduced version (rTNS) at baseline and at 4 months after initiation of chemotherapy. A multivariate analysis identified predictors with the strongest association with a change in rTNS. Serum albumin (P = .002), paclitaxel dose (P = .001), and body surface area (P = .006) were statistically significantly associated with a positive rTNS change (worsening neuropathy). These results suggest that poor nutritional status and obesity increase the risk of paclitaxel induced neuropathy, and that screening for these factors prior to chemotherapy exposure may improve early neuropathy detection or decrease risk with dietary modifications.
周围神经病变是许多化疗药物（包括紫杉醇）的常见副作用。我们前瞻性地评估了 61 名乳腺癌女性在接受紫杉醇暴露前的人口统计学和实验室数据，以探讨易患神经病变发展的因素。神经病变根据基线和化疗开始后 4 个月的总神经病变评分简化版（rTNS）进行分级。多变量分析确定了与 rTNS 变化最强相关的预测因素。血清白蛋白（P =.002）、紫杉醇剂量（P =.001）和体表面积（P =.006）与 rTNS 变化（神经病变恶化）呈统计学显著相关。这些结果表明，营养状况差和肥胖增加了紫杉醇引起的神经病变的风险，并且在化疗暴露前对这些因素进行筛查可能会改善早期神经病变的检测或通过饮食改变降低风险。
