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卵巢癌患者的化疗引起的周围神经病。

Chemotherapy-induced peripheral neuropathy among patients with ovarian cancer.

机构信息

Department of Gynecology, Xiangya Hospital, Central South University, Changsha, China.

Gynecological Oncology Research and Engineering Center of Hunan Province, Changsha, China.

出版信息

Int J Gynaecol Obstet. 2020 Jun;149(3):303-308. doi: 10.1002/ijgo.13137. Epub 2020 Apr 1.

Abstract

OBJECTIVE

To evaluate the course of chemotherapy-induced peripheral neuropathy (CIPN) among patients with ovarian cancer receiving taxanes.

METHODS

In a retrospective case-control study conducted between January 1, 2016, and May 31, 2018, in Xiangya Hospital in Changsha, China, women with ovarian cancer received taxane and platinum-complex combination therapy. The European Organization for Research and Treatment of Cancer Quality of Life, Ovarian cancer module questionnaire, was used to assess the severity of neuropathy by telephone.

RESULTS

Out of the 88 women included in the study, 61 (69.3%) reported CIPN. Twelve months after chemotherapy, the percentage was 19.3%. The percentage of patients suffering from sensory peripheral neuropathy (SPN) was higher than motor peripheral neuropathy at any time during the study. Sensory peripheral neuropathy was associated with the use of docetaxel and paclitaxel (docetaxel vs liposomal paclitaxel: odds ratio [OR] 4.39, 95% confidence interval [CI] 1.69-11.42, P<0.01; paclitaxel vs liposomal paclitaxel: OR 5.91, 95% CI 1.09-31.97, P=0.04). The average weakness score in acute CIPN was lower than chronic CIPN (1.46 vs 2.00, P=0.019). Patients treated with vitamin B and amifostine experienced better relief from CIPN.

CONCLUSION

The present study showed a significant proportion of patients with ovarian cancer receiving taxanes suffered from long-term residual neuropathy, and the use of docetaxel and paclitaxel was associated with SPN. Vitamin B or amifostine may improve the symptoms of CIPN.

摘要

目的

评估接受紫杉烷类药物治疗的卵巢癌患者化疗引起的周围神经病变(CIPN)的病程。

方法

本研究为回顾性病例对照研究,于 2016 年 1 月 1 日至 2018 年 5 月 31 日在中国长沙湘雅医院进行,研究对象为接受紫杉烷类药物和铂类复合物联合治疗的卵巢癌患者。采用欧洲癌症研究与治疗组织生活质量问卷卵巢癌模块通过电话评估神经病变严重程度。

结果

研究共纳入 88 例患者,其中 61 例(69.3%)报告有 CIPN。化疗后 12 个月,这一比例为 19.3%。在研究过程中的任何时候,感觉周围神经病变(SPN)患者的比例均高于运动周围神经病变患者。感觉周围神经病变与使用多西他赛和紫杉醇相关(多西他赛与脂质体紫杉醇:比值比 [OR] 4.39,95%置信区间 [CI] 1.69-11.42,P<0.01;紫杉醇与脂质体紫杉醇:OR 5.91,95%CI 1.09-31.97,P=0.04)。急性 CIPN 的平均乏力评分低于慢性 CIPN(1.46 与 2.00,P=0.019)。接受维生素 B 和氨磷汀治疗的患者 CIPN 缓解情况更好。

结论

本研究表明,接受紫杉烷类药物治疗的卵巢癌患者有相当比例患有长期残留性神经病变,且使用多西他赛和紫杉醇与 SPN 相关。维生素 B 或氨磷汀可能改善 CIPN 的症状。

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