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在开始紫杉烷类化疗前出现焦虑症状但无抑郁症状与周围神经病变相关:一项针对乳腺癌女性的多中心研究。

Symptoms of anxiety but not depression before start of taxane-based chemotherapy are associated with peripheral neuropathy: a multicenter study in women with breast cancer.

机构信息

Oncology Centre, Psycho-Oncology, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.

Gynaecology Department, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Support Care Cancer. 2022 Aug;30(8):6947-6953. doi: 10.1007/s00520-022-07093-4. Epub 2022 May 11.

Abstract

BACKGROUND

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy, especially after taxane-based therapy. This study aimed to examine the relationship between symptoms of anxiety and depression before the start of taxane-based chemotherapy and the development of CIPN in women with breast cancer.

METHODS

In this prospective study, women with breast cancer receiving taxane-based (neo)adjuvant chemotherapy were recruited from four hospitals in the Netherlands. Patients completed questionnaires assessing anxiety and depressive symptoms before treatment and CIPN before treatment (T0), 6 weeks after start of treatment (T1), after the last cycle of chemotherapy (T2), and 6 months after the end of treatment (T3). Mixed model analyses were used to investigate whether medium/high levels of anxiety or depression at baseline are associated with the level of CIPN during and after treatment.

RESULTS

Among the 61 participating women, 14 (23%) reported medium/high levels of anxiety and 29 (47.5%) reported medium/high levels of depressive symptoms at baseline. The group of women with medium/high baseline levels of anxiety showed a significantly higher increase in CIPN during and after chemotherapy than women with low baseline levels of anxiety (p < .001). No relationship between depressive symptoms at baseline and the development of CIPN was found.

CONCLUSION

This study showed that baseline medium to high levels of anxiety but not depressive symptoms impacted the development of CIPN during and in the 6 months after treatment.

摘要

背景

化疗引起的周围神经病(CIPN)是化疗的常见副作用,尤其是在紫杉烷类药物治疗后。本研究旨在探讨乳腺癌女性在开始紫杉烷类(新)辅助化疗前焦虑和抑郁症状与 CIPN 发展之间的关系。

方法

在这项前瞻性研究中,从荷兰的四家医院招募了正在接受紫杉烷类(新)辅助化疗的乳腺癌患者。患者在治疗前(T0)、治疗开始后 6 周(T1)、化疗最后一个周期后(T2)和治疗结束后 6 个月(T3)完成了评估焦虑和抑郁症状的问卷。混合模型分析用于研究基线时中/高度焦虑或抑郁水平是否与治疗期间和治疗后的 CIPN 水平相关。

结果

在 61 名参与的女性中,14 名(23%)报告基线时存在中/高度焦虑,29 名(47.5%)报告基线时存在中/高度抑郁症状。基线时中/高度焦虑水平的女性在化疗期间和之后 CIPN 的增加明显高于基线时低焦虑水平的女性(p<0.001)。基线时的抑郁症状与 CIPN 的发展之间没有关系。

结论

本研究表明,基线时中高度的焦虑而不是抑郁症状会影响治疗期间和治疗后 6 个月 CIPN 的发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beea/9213366/af5768b87041/520_2022_7093_Fig1_HTML.jpg

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