Department of Nursing, University of Ulsan, Ulsan, Republic of Korea.
Division of Hematology-Oncology, Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
Anticancer Res. 2021 May;41(5):2637-2645. doi: 10.21873/anticanres.15044.
BACKGROUND/AIM: Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common chemotoxicities. However, no effective clinical CIPN screening methods have been reported. This study aimed to investigate whether changes in heart rate variability (HRV) could predict the development of CIPN for early symptom control in chemotherapy-prescribed patients with gastrointestinal (GI) cancer.
Fifty-five GI cancer outpatients undergoing palliative chemotherapy including taxanes and/or platinum compounds were enrolled. CIPN was diagnosed using National Cancer Institute Common Toxicity Criteria for Adverse Event (NCI-CTCAE). HRV measures were derived from electrocardiogram signals.
Twelve weeks after starting chemotherapy, 39 (70.9%) patients who complained of NCI-CTCAE grade 1-3 sensory changes were diagnosed with CIPN. Standard deviation of normal-to-normal R-R intervals (SDNN), high frequency (HF), low frequency (LF), and LF/HF ratio changed significantly during 3 assessment periods. Percentage changes in SDNN and HF were related to the occurrence of CIPN symptoms. A decision tree model indicated that patients with a rapid percentage change decrease in SDNN and HF were CIPN-positive.
Using SDNN and HF, our decision tree predicted CIPN occurrence. The changes in HRV may occur earlier than sensory CIPN symptoms.
背景/目的：化疗引起的周围神经病（CIPN）是最常见的化疗毒性之一。然而，目前尚未报道有效的临床 CIPN 筛查方法。本研究旨在探讨心率变异性（HRV）的变化是否可以预测胃肠道（GI）癌症接受化疗的患者 CIPN 的发生，以便对早期症状进行控制。
共纳入 55 名接受包括紫杉烷类和/或铂类化合物在内的姑息性化疗的 GI 癌症门诊患者。CIPN 的诊断采用美国国立癌症研究所不良事件常见毒性标准（NCI-CTCAE）。HRV 测量来自心电图信号。
在开始化疗 12 周后，39 名（70.9%）抱怨 NCI-CTCAE 1-3 级感觉变化的患者被诊断为 CIPN。正常到正常 R-R 间隔的标准差（SDNN）、高频（HF）、低频（LF）和 LF/HF 比值在 3 个评估期间均发生显著变化。SDNN 和 HF 的百分比变化与 CIPN 症状的发生有关。决策树模型表明，SDNN 和 HF 百分比快速下降的患者为 CIPN 阳性。
使用 SDNN 和 HF，我们的决策树预测了 CIPN 的发生。HRV 的变化可能早于感觉性 CIPN 症状出现。
