Hsu Hsin-Tien, Wu Li-Min, Lin Pei-Chao, Juan Chiung-Hui, Huang Yu-Yen, Chou Pi-Ling, Chen Jyu-Lin
School of Nursing, College of Nursing, Kaohsiung Medical University, Taiwan.
Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan.
Medicine (Baltimore). 2020 Feb;99(6):e19029. doi: 10.1097/MD.0000000000019029.
When the 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) chemotherapy regimen is used to treat colorectal cancer (CRC), chemotherapy-induced peripheral neuropathy (CIPN) caused by oxaliplatin can substantially affect quality of life (QOL) in the CRC patients. This study compared emotional distress and QOL during FOLFOX in CRC patients with and without CIPN symptoms.This cross-sectional, descriptive, and comparative study recruited 68 CRC patients receiving FOLFOX at a local teaching hospital and at a medical center in southern Taiwan. Self-reported structured questionnaires (oxaliplatin-associated neuropathy questionnaire, profile of mood states short form, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core 30, version 3.0) were used for 1-time data collection. The Chi-square test, Fisher exact test, and Mann-Whitney U test were used to analyze data, and a P-value < .05 was considered statistically significant.The CIPN group had 45 (66.2%) patients, and the non-CIPN group had 23 (33.8%) patients. The 5 most common symptoms were coldness-related burning sensation or discomfort in the upper limbs, numbness in the upper limbs, tingling in the upper limbs, impairment of vision, and discomfort in the throat. The CIPN group had more females (P = .013), a more advanced stage of CRC (P = .04) and a higher chemotherapy dosage (P = .006). The 2 groups did not significantly differ in anxiety (P = .065) or depression (P = .135). Compared to the non-CIPN group, the CIPN group had significantly lower functioning (P = .001) and global health status (P < .001) and significantly more symptoms (P < .001).The CIPN group had significantly lower QOL compared to the non-CIPN group. However, the CIPN group did not have lower emotional distress compared to the non-CIPN group. The results of this study demonstrate the need for in-service courses specifically designed to train health professionals in assessing and managing CIPN symptoms to improve QOL in CRC patients receiving FOLFOX.
当采用氟尿嘧啶、亚叶酸钙和奥沙利铂（FOLFOX）化疗方案治疗结直肠癌（CRC）时，奥沙利铂引起的化疗诱导的周围神经病变（CIPN）会严重影响CRC患者的生活质量（QOL）。本研究比较了有和没有CIPN症状的CRC患者在接受FOLFOX化疗期间的情绪困扰和生活质量。这项横断面、描述性和比较性研究招募了68名在台湾南部一家当地教学医院和一家医疗中心接受FOLFOX化疗的CRC患者。采用自我报告的结构化问卷（奥沙利铂相关神经病变问卷、情绪状态简表和欧洲癌症研究与治疗组织生活质量问卷核心30版，第3.0版）进行一次性数据收集。使用卡方检验、Fisher精确检验和Mann-Whitney U检验分析数据，P值<0.05被认为具有统计学意义。CIPN组有45名（66.2%）患者，非CIPN组有23名（33.8%）患者。最常见的5种症状是上肢与寒冷相关的灼痛或不适、上肢麻木、上肢刺痛、视力障碍和喉咙不适。CIPN组女性更多（P=0.013），CRC分期更晚（P=0.04），化疗剂量更高（P=0.006）。两组在焦虑（P=0.065）或抑郁（P=0.135）方面无显著差异。与非CIPN组相比，CIPN组的功能（P=0.001）和总体健康状况（P<0.001）显著更低，症状显著更多（P<0.001）。与非CIPN组相比，CIPN组的生活质量显著更低。然而，与非CIPN组相比，CIPN组的情绪困扰并没有更低。本研究结果表明，需要专门设计在职课程，培训卫生专业人员评估和管理CIPN症状，以提高接受FOLFOX化疗的CRC患者的生活质量。
