Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Cancer Med. 2020 Jul;9(14):5114-5123. doi: 10.1002/cam4.3129. Epub 2020 May 29.
The aim of this study was to assess chemotherapy-induced polyneuropathy (CIPN) 5 years after adjuvant chemotherapy in patients with breast and colorectal cancer. The association of CIPN with quality of life, anxiety, and depression was analyzed.
Of a set of 100 patients with breast cancer and of 74 with colorectal cancer who had undergone surgery and adjuvant chemotherapy in 2011-2012, 80 and 52 patients alive, respectively, were included together with two reference groups of 249 breast cancer patients and 83 colorectal cancer patients who had undergone surgery only. All patients were sent a questionnaire on alcohol consumption, smoking habits, comorbidity, medicine consumption, and oxaliplatin-specific questions, as well as the Michigan Neuropathy Screening Instrument questionnaire (MNSIq), the Douleur Neuropathique 4 Questions (DN4q), the EQ-5D, and the Hospital Anxiety and Depression Scale. Possible polyneuropathy was defined as the presence of numbness and/or tingling in the feet, secondly as a score of ≥4 on the MNSIq. Possible painful polyneuropathy was defined as pain in both feet and a score ≥3 on the DN4q.
The prevalence of possible polyneuropathy defined by numbness and/or tingling in the feet was 38.8% (28.1-50.3) after adjuvant docetaxel and 57.7% (43.2-71.3) after adjuvant oxaliplatin, with no significant difference from a previous 1-year follow-up (P >.35). Fewer had possible polyneuropathy as defined by the MNSIq. Patients with possible polyneuropathy after adjuvant chemotherapy reported significantly lower quality of life than patients treated with surgery only.
Symptoms of polyneuropathy following adjuvant docetaxel and oxaliplatin persist 5 years after treatment and affect quality of life negatively.
本研究旨在评估乳腺癌和结直肠癌患者接受辅助化疗 5 年后的化疗诱导性多发性神经病（CIPN）。分析 CIPN 与生活质量、焦虑和抑郁的关系。
对 2011-2012 年接受手术和辅助化疗的 100 例乳腺癌患者和 74 例结直肠癌患者进行了一组研究，其中 80 例乳腺癌患者和 52 例结直肠癌患者存活，另外还有两组参考组，每组 249 例乳腺癌患者和 83 例仅接受手术的结直肠癌患者。所有患者均收到一份关于饮酒、吸烟习惯、合并症、用药和奥沙利铂具体问题的问卷，以及密歇根神经筛查工具问卷（MNSIq）、4 个神经痛问题问卷（DN4q）、EQ-5D 和医院焦虑抑郁量表。可能的多发性神经病定义为脚部麻木和/或刺痛感，其次是 MNSIq 评分≥4。可能的痛性多发性神经病定义为双脚疼痛和 DN4q 评分≥3。
辅助多西紫杉醇后出现脚部麻木和/或刺痛的可能多发性神经病的患病率为 38.8%（28.1-50.3），辅助奥沙利铂后为 57.7%（43.2-71.3），与之前的 1 年随访相比无显著差异（P>.35）。MNSIq 定义的可能多发性神经病患者较少。接受辅助化疗后出现可能多发性神经病的患者报告的生活质量明显低于仅接受手术治疗的患者。
辅助多西紫杉醇和奥沙利铂治疗后 5 年仍存在多发性神经病症状，并对生活质量产生负面影响。
