Oyama Fumie, Futagami Masayuki, Oikiri Hiroe, Takabayashi Anna, Akaishi Asami, Kodama Tomoe, Matsumoto Mami, Kanamori Masahiro, Oishi Maika, Miura Rie, Hirakawa Hachidai, Yokoyama Yoshihito
Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan.
Mol Clin Oncol. 2020 Aug;13(2):169-174. doi: 10.3892/mco.2020.2056. Epub 2020 Jun 3.
Chemotherapy-induced peripheral neuropathy (CIPN) is a frequently observed treatment-related adverse effect, particularly associated with taxane-based chemotherapy, which affects the quality of life of the patients. To date, CIPN has been subjectively evaluated by patients or physicians. Intraepidermal electrical stimulation (IES) may be applied to evaluate the function of small fibers by measuring pain threshold, and assess the degree of diabetic peripheral neuropathy. The aim of the present study was to evaluate CIPN objectively by using IES. The pain threshold measured by IES in patients with gynecological cancer who underwent taxane-based chemotherapy was compared with the clinical grading scale of peripheral neuropathy (National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0). A total of 57 patients were evaluated (151 measurements). The median age of the patients was 63 years. The number of measurements with clinical grades of 0, 1 and ≥2 was 49, 57 and 45, respectively. The mean pain threshold was 0.1, 0.14 and 0.18 mA for grades 0, 1 and ≥2, respectively. Therefore, the mean pain threshold significantly increased with the progression of the clinical grade. The measurement of pain threshold by using IES may be a reliable indicator for quantitative evaluation of CIPN.
化疗引起的周围神经病变（CIPN）是一种常见的与治疗相关的不良反应，尤其与紫杉烷类化疗相关，它会影响患者的生活质量。迄今为止，CIPN一直由患者或医生进行主观评估。表皮内电刺激（IES）可用于通过测量疼痛阈值来评估小纤维的功能，并评估糖尿病周围神经病变的程度。本研究的目的是使用IES客观评估CIPN。将接受紫杉烷类化疗的妇科癌症患者通过IES测量的疼痛阈值与周围神经病变的临床分级量表（美国国立癌症研究所不良事件通用术语标准，第4.0版）进行比较。共评估了57例患者（进行了151次测量）。患者的中位年龄为63岁。临床分级为0、1和≥2级的测量次数分别为49、57和45次。0、1和≥2级的平均疼痛阈值分别为0.1、0.14和0.18 mA。因此，平均疼痛阈值随着临床分级的进展而显著增加。使用IES测量疼痛阈值可能是定量评估CIPN的可靠指标。
