Memorial Sloan Kettering Cancer Center, New York, NY, USA.
University of Michigan, Ann Arbor, MI, USA.
Breast Cancer Res Treat. 2019 Dec;178(3):587-595. doi: 10.1007/s10549-019-05416-4. Epub 2019 Aug 27.
CIPN is a common, debilitating, and dose-limiting side effect of chemotherapy. Here, we describe characteristics of patients with CIPN using both patient-reported outcomes (PRO) and quantitative sensory testing (QST).
Breast cancer survivors with persistent moderate to severe CIPN defined by a rating of 4 or greater on a 0-10 Numeric Rating Scale (NRS) from two ongoing clinical trials were included. PROs included the Neuropathic Pain Scale (NPS) and Functional Assessment of Cancer Therapy-Gynecologic Oncology Group/Neurotoxicity (FACT/GOG-Ntx). QST included tactile and vibration detection threshold measurements. Data were analyzed using descriptive statistics and Spearman correlation coefficients.
49 female patients with a mean age of 61 years were assessed; 63% were Caucasian. Mean NRS scores were 4.2, 5.7, and 4.3 on 0-10 scale for pain, numbness, and tingling, respectively. Mean NPS score was 41.0 on a 0-100 scale, and the mean FACT/GOG-Ntx score was 25.8 on a 0-44 scale. QST showed mild to moderate impairments in tactile and vibration perception. The FACT/GOG-Ntx subscale for numbness was negatively correlated with tactile and vibration thresholds in both hands and feet (both p < 0.05). NPS was positively correlated with tactile thresholds in the hands and feet (p < 0.05).
Patients with moderate to severe CIPN report moderate pain, numbness, and tingling, and exhibit reduced tactile and vibration perception on QST. Weak to moderate correlations were observed between PRO and QST. These data suggest that QST outcomes are associated with CIPN symptoms and may be useful in helping monitor and manage CIPN treatment.
周围神经病变(CIPN)是化疗的一种常见、使人虚弱且剂量受限的副作用。在这里,我们通过患者报告的结局(PRO)和定量感觉测试(QST)来描述 CIPN 患者的特征。
纳入了两项正在进行的临床试验中,持续性中度至重度 CIPN 的乳腺癌幸存者,其定义为 0-10 数字评分量表(NRS)的评分≥4(范围 0-10,得分越高表示疼痛越剧烈)。PRO 包括神经性疼痛量表(NPS)和癌症治疗功能评估/妇科肿瘤组-神经毒性(FACT/GOG-Ntx)。QST 包括触觉和振动觉检测阈值测量。使用描述性统计和斯皮尔曼相关系数进行数据分析。
评估了 49 名平均年龄为 61 岁的女性患者,其中 63%为白种人。疼痛、麻木和刺痛的 NRS 评分分别为 0-10 评分的 4.2、5.7 和 4.3。NPS 评分为 0-100 评分的 41.0,FACT/GOG-Ntx 评分为 0-44 评分的 25.8。QST 显示触觉和振动觉轻度至中度受损。FACT/GOG-Ntx 麻木亚量表与双手和双脚的触觉和振动阈值呈负相关(均 p<0.05)。NPS 与手和脚的触觉阈值呈正相关(p<0.05)。
中度至重度 CIPN 患者报告中度疼痛、麻木和刺痛,并在 QST 上表现出触觉和振动觉减退。PRO 与 QST 之间观察到弱至中度相关性。这些数据表明 QST 结果与 CIPN 症状相关,可能有助于监测和管理 CIPN 治疗。