Department of Outpatient Oncology Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Clinical Practical Pharmacy for Education, Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka, 569-1094, Japan.
Support Care Cancer. 2019 Jul;27(7):2673-2677. doi: 10.1007/s00520-018-4571-9. Epub 2018 Nov 26.
This retrospective study was undertaken to identify predictive factors for developing taxane acute pain syndrome (TAPS) and to determine new strategies for improving QoL in patients undergoing chemotherapy. Between November 2010 and May 2018, we enrolled 121 breast cancer patients at our outpatient chemotherapy center who were undergoing chemotherapy with nanoparticle albumin-bound paclitaxel (nab-PTX) every 3 weeks. Variables related to the development of TAPS were extracted from the patients' clinical records and used for regression analysis. The degree of TAPS was classified as grade 0 = not developed; grade 1 = developed but did not require analgesics; grade 2 = developed but alleviated by analgesics such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs); or grade 3 = syndrome developed, causing sleep problems or interfering with daily living activities, but not alleviated by analgesics such as acetaminophen or NSAIDs thus requiring opioids. Multivariate ordered logistic regression analysis was performed to identify predictive factors for the development of TAPS. Significant factors identified for the development of TAPS included dose of nab-PTX (odds ratio (OR) = 11.717, 95% confidence interval (CI) = 11.6161-11.8182; P = 0.0421) and the administration of dexamethasone for up to 3 days (OR = 0.133, 95% CI = 0.0235-0.7450; P = 0.0223). In conclusion, a high dose of nab-PTX and the lack of dexamethasone administration for up to 3 days were identified as significant predictors of the development of TAPS.
本回顾性研究旨在确定发生紫杉烷急性疼痛综合征（TAPS）的预测因素，并确定改善接受化疗患者生活质量的新策略。在 2010 年 11 月至 2018 年 5 月期间，我们在我院门诊化疗中心招募了 121 例正在接受每 3 周一次纳米白蛋白结合紫杉醇（nab-PTX）化疗的乳腺癌患者。从患者的临床记录中提取与 TAPS 发展相关的变量，并用于回归分析。TAPS 的严重程度分为 0 级=未发生；1 级=已发生但无需使用镇痛药；2 级=已发生但通过对乙酰氨基酚或非甾体抗炎药（NSAIDs）等镇痛药缓解；3 级=综合征已发生，导致睡眠问题或干扰日常生活活动，但对乙酰氨基酚或 NSAIDs 等镇痛药无效，因此需要阿片类药物。进行多变量有序逻辑回归分析以确定 TAPS 发展的预测因素。TAPS 发生的显著因素包括 nab-PTX 剂量（比值比（OR）=11.717，95%置信区间（CI）=11.6161-11.8182；P=0.0421）和地塞米松给药长达 3 天（OR=0.133，95%CI=0.0235-0.7450；P=0.0223）。总之，高剂量的 nab-PTX 和缺乏地塞米松给药长达 3 天是 TAPS 发展的重要预测因素。
