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台湾地区结直肠癌患者中急性和慢性奥沙利铂诱导的周围神经病变的发生率、严重程度、纵向趋势及预测因素

Incidence, severity, longitudinal trends and predictors of acute and chronic oxaliplatin-induced peripheral neuropathy in Taiwanese patients with colorectal cancer.

作者信息

Hsu Shu-Yi, Huang Wen-Shih, Lee Shu-Hui, Chu Tsui-Ping, Lin Yung-Chang, Lu Chang-Hsien, Beaton Randal D, Jane Sui-Whi

机构信息

Department of Internal Medicine, Chia-Yi Christian Hospital, Chia-Yi, Taiwan.

Division of Colon/Rectal, Department of Surgical Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan.

出版信息

Eur J Cancer Care (Engl). 2019 Mar;28(2):e12976. doi: 10.1111/ecc.12976. Epub 2018 Dec 10.

Abstract

The purpose of this study was to evaluate the longitudinal incidence, severity, pattern of changes or predictors of oxaliplatin-induced peripheral neuropathy (OXAIPN) in Taiwanese patients with colorectal cancer. A longitudinal repeated measures study design was employed, and 77 participants were recruited from the colorectal and oncology departments of two teaching medical centres in Taiwan. Physical examinations were performed, and self-reports regarding adverse impacts of OXAIPN and quality of life were obtained at five time points throughout 12 cycles of chemotherapy (C/T). The incidence of OXAIPN increased with C/T cycles (31.1%-81.9%), and the upper limb numbness and cold sensitivity were most significant acute OXAIPN symptoms (29.9%-73.6%). Findings also documented significant increases in overall severity, symptom distress, interference and physical results associated with OXAIPN over the course of C/T. Predictors of OXAIPN severity varied by treatment cycle, including younger patient, higher cumulative dose of oxaliplatin, greater body surface area, receipt of chemotherapy in winter and the occurrence of OXAIPN during prior C/T cycles. The results from this study might help healthcare providers to recognise the symptom characteristics, degree of influences, trends and high-risk group of OXAIPN, facilitating early evaluation and potential interventions to mitigate or prevent negative effects of OXAIPN on patients.

摘要

本研究旨在评估台湾地区结直肠癌患者中奥沙利铂诱导的周围神经病变(OXAIPN)的纵向发病率、严重程度、变化模式或预测因素。本研究采用纵向重复测量研究设计,从台湾两所教学医学中心的结直肠科和肿瘤科招募了77名参与者。在整个12个化疗周期(C/T)的五个时间点进行了体格检查,并获取了关于OXAIPN不良影响和生活质量的自我报告。OXAIPN的发病率随C/T周期增加(31.1%-81.9%),上肢麻木和冷敏感是最显著的急性OXAIPN症状(29.9%-73.6%)。研究结果还表明,在C/T过程中,与OXAIPN相关的总体严重程度、症状困扰、干扰和身体结果均显著增加。OXAIPN严重程度的预测因素因治疗周期而异,包括年轻患者、奥沙利铂累积剂量较高、体表面积较大、在冬季接受化疗以及在前一个C/T周期中发生OXAIPN。本研究结果可能有助于医疗保健提供者识别OXAIPN的症状特征、影响程度、趋势和高危人群,促进早期评估和潜在干预措施,以减轻或预防OXAIPN对患者的负面影响。

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