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年轻和老年乳腺癌幸存者上肢化疗引起的周围神经病变症状的存在与痛苦程度

Presence and Distress of Chemotherapy-Induced Peripheral Neuropathy Symptoms in Upper Extremities of Younger and Older Breast Cancer Survivors.

作者信息

Storey Susan, Cohee Andrea, Von Ah Diane, Vachon Eric, Zanville Noah R, Monahan Patrick O, Stump Timothy E, Champion Victoria L

机构信息

Indiana University School of Nursing, Indianapolis, IN.

Miami Cancer Institute, Baptist Health South Florida, Miami, FL.

出版信息

J Patient Cent Res Rev. 2020 Oct 23;7(4):295-303. doi: 10.17294/2330-0698.1757. eCollection 2020 Fall.

Abstract

PURPOSE

The purposes of this study were to determine whether the presence of upper extremity chemotherapy-induced peripheral neuropathy (CIPN) symptoms (burning, pins/needles, numbness, pain, and skin crawls) among breast cancer survivors (BCS) varied according to age (≤45 years or 55-70 years) and to examine age group differences in upper extremity CIPN symptom distress.

METHODS

The study was a secondary analysis of younger (n=505) and older (n=622) BCS. Inclusion criteria were age of ≤45 years or 55-70 years; patient at 3-8 years postdiagnosis; patient received the chemotherapy regimen of paclitaxel, doxorubicin, and cyclophosphamide; and patient did not have recurrence. The Symptom Survivor Checklist was used to assess presence and distress of upper extremity CIPN symptoms. Analyses explored whether age group predicted CIPN symptom presence and distress while controlling for sociodemographic and medical variables.

RESULTS

Older BCS reported fewer pins/needles, numbness, and pain symptoms (odds ratios: 0.623-0.751). Heart disease (odds ratios: 1.59-1.70) and progesterone-negative breast cancer (odds ratio: 0.663) were significantly associated with one or more CIPN symptoms. Symptom distress ratings did not differ by age groups; both age groups indicated distress from CIPN symptoms, with 25% or more reporting distress as "moderately" or "quite a bit."

CONCLUSIONS

Younger BCS reported more upper extremity CIPN symptoms. BCS in both groups continued to report bothersome CIPN symptoms years after treatment. Study findings will assist clinicians in identifying BCS at higher risk for upper extremity CIPN as well as inform development of appropriate tailored interventions to mitigate these symptoms and facilitate restoration to age-related baseline function, thereby improving quality of life for BCS.

摘要

目的

本研究的目的是确定乳腺癌幸存者(BCS)中上肢化疗引起的周围神经病变(CIPN)症状(灼痛、刺痛/麻木感、麻木、疼痛和皮肤蚁走感)的出现是否因年龄(≤45岁或55 - 70岁)而异,并检查上肢CIPN症状困扰方面的年龄组差异。

方法

该研究是对年轻(n = 505)和年长(n = 622)乳腺癌幸存者的二次分析。纳入标准为年龄≤45岁或55 - 70岁;诊断后3 - 8年的患者;接受过紫杉醇、阿霉素和环磷酰胺化疗方案的患者;且无复发的患者。使用症状幸存者清单评估上肢CIPN症状的出现和困扰情况。分析在控制社会人口统计学和医学变量的同时,探讨年龄组是否可预测CIPN症状的出现和困扰。

结果

年长的乳腺癌幸存者报告的刺痛/麻木感、麻木和疼痛症状较少(优势比:0.623 - 0.751)。心脏病(优势比:1.59 - 1.70)和孕激素阴性乳腺癌(优势比:0.663)与一种或多种CIPN症状显著相关。症状困扰评分在年龄组之间没有差异;两个年龄组均表示CIPN症状带来困扰,25%或更多的人报告困扰程度为“中度”或“相当严重”。

结论

年轻的乳腺癌幸存者报告的上肢CIPN症状更多。两组乳腺癌幸存者在治疗多年后仍报告有令人烦恼的CIPN症状。研究结果将帮助临床医生识别上肢CIPN风险较高的乳腺癌幸存者,并为制定适当的针对性干预措施提供信息,以减轻这些症状并促进恢复到与年龄相关的基线功能,从而改善乳腺癌幸存者的生活质量。

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