Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, 1600 Divisadero Street, San Francisco, CA, 94115, USA.
School of Nursing Office of Research, University of California, San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA.
Support Care Cancer. 2019 Oct;27(10):3905-3912. doi: 10.1007/s00520-019-04695-3. Epub 2019 Feb 15.
While older adults with cancer are more likely to develop chemotherapy-induced peripheral neuropathy (CIPN), the study aimed to determine if patient-reported and objective measures of CIPN differ by age among cancer survivors.
Cancer survivors with persistent CIPN after completion of platinum and/or taxane chemotherapy completed CIPN questionnaires (severity, interference with activities, sensory, and motor symptoms) and objective testing (light touch, vibration, pain, cold sensation). CIPN measures were compared by age group (< 65 n = 260 versus ≥ 65 n = 165) using parametric and nonparametric tests.
Among 425 cancer survivors with CIPN, mean age was 60.9 (SD 10.5). CIPN location did not differ by age (overall 68% hands and feet, 27% only feet, 5% only hands). For patient-reported measures, older survivors reported less severe pain in the hands and feet than younger survivors. In addition, older survivors reported lower interference with general activity, routine activities, normal work, enjoyment of life, sleep, mood, relations with other people, and sexual activity. No age differences in sensory and motor symptom scores were found. In contrast, for objective measures, older survivors had worse light touch and cold sensations in their feet and worse vibration detection in their hands and feet.
Despite having worse light touch, cold, and vibration sensations, older cancer survivors with CIPN reported less severe pain and interference with activities. This discordance highlights the importance of including both patient-reported and objective measures to assess CIPN in cancer survivors to better evaluate this clinical condition.
尽管老年癌症患者更易发生化疗引起的周围神经病(CIPN),但本研究旨在确定在癌症幸存者中,CIPN 的患者报告和客观测量是否因年龄而异。
完成铂类和/或紫杉烷化疗后持续存在 CIPN 的癌症幸存者完成了 CIPN 问卷(严重程度、对活动的干扰、感觉和运动症状)和客观测试(轻触、振动、疼痛、冷感)。使用参数和非参数检验比较按年龄组(<65 岁 n=260 与≥65 岁 n=165)的 CIPN 测量值。
在 425 名患有 CIPN 的癌症幸存者中,平均年龄为 60.9(SD 10.5)。CIPN 的位置不因年龄而异(总体上 68%为手和脚,27%仅为脚,5%仅为手)。对于患者报告的测量值,年龄较大的幸存者在手和脚上报告的疼痛程度较轻。此外,年龄较大的幸存者报告对一般活动、日常活动、正常工作、生活享受、睡眠、情绪、与他人的关系和性生活的干扰较小。在感觉和运动症状评分方面,未发现年龄差异。相比之下,对于客观测量值,年龄较大的幸存者的脚部轻触和冷感较差,手部和脚部的振动检测较差。
尽管年龄较大的癌症幸存者的 CIPN 患者报告的轻触、冷和振动感觉较差,但他们报告的疼痛和活动干扰程度较轻。这种不匹配突出了在癌症幸存者中评估 CIPN 时同时使用患者报告和客观测量的重要性,以更好地评估这种临床状况。