Department of Outpatient Oncology Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Endocrine and Breast Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Med Oncol. 2022 Jul 19;39(10):153. doi: 10.1007/s12032-022-01754-4.
In a previous study, we showed that cryotherapy and compression therapy have comparable efficacy in preventing nab-paclitaxel-induced peripheral neuropathy. However, even with cryotherapy or compression therapy, there were patients with National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 grade ≥ 2 and/or Patient Neurotoxicity Questionnaire (PNQ) grade ≥ D peripheral neuropathies. Therefore, this post hoc analysis was performed to identify predictors of nab-paclitaxel-induced peripheral neuropathy. The clinical data in this post hoc analysis were the data of 38 breast cancer patients receiving chemotherapy with nanoparticle albumin-bound paclitaxel (nab-PTX) at our outpatient chemotherapy center from August 2017 to March 2019. The number of patients was analyzed assuming that there were data for 76 hands. Variables related to the development of nab-PTX-induced peripheral neuropathy were used for regression analysis. Multivariate-ordered logistic regression analysis was performed to identify predictors for the development of nab-PTX-induced peripheral neuropathy. Significant factors included smoking history [odds ratio (OR) 4.64, 95% confidence interval (CI) 1.60-13.5; P = 0.0048] with neuropathy evaluated by CTCAE, body mass index (BMI) (OR 1.13, 95% CI 1.01-1.26; P = 0.039) with neuropathy evaluated by PNQ (sensory), and smoking history (OR 3.80, 95% CI 1.40-10.30; P = 0.0087) and age (OR 1.06, 95% CI 1.01-1.11; P = 0.012) with neuropathy evaluated by PNQ (motor). In conclusion, smoking history, BMI and age were identified as significant predictors of the development of nab-PTX-induced-peripheral neuropathy.
在之前的研究中，我们表明冷冻疗法和压缩疗法在预防纳武利尤单抗联合紫杉醇引起的周围神经病变方面具有相当的疗效。然而，即使使用冷冻疗法或压缩疗法，仍有患者出现美国国立癌症研究所不良事件通用术语标准（CTCAE）第 4.0 版≥2 级和/或患者神经毒性问卷（PNQ）≥D 级周围神经病变。因此，进行了这项事后分析以确定纳武利尤单抗联合紫杉醇引起的周围神经病变的预测因素。本次事后分析的临床数据来自于我们的门诊化疗中心于 2017 年 8 月至 2019 年 3 月期间接受白蛋白结合型紫杉醇（nab-PTX）化疗的 38 例乳腺癌患者的数据。假设分析中共有 76 只手的数据，对患者数量进行了分析。用于回归分析的变量包括与纳武利尤单抗联合紫杉醇诱导的周围神经病发生相关的变量。进行多变量有序逻辑回归分析以确定纳武利尤单抗联合紫杉醇诱导的周围神经病发生的预测因素。显著因素包括吸烟史[比值比（OR）4.64，95%置信区间（CI）1.60-13.5；P=0.0048]，CTCAE 评估的周围神经病，体质指数（BMI）（OR 1.13，95%CI 1.01-1.26；P=0.039），PNQ（感觉）评估的周围神经病，以及吸烟史[OR 3.80，95%CI 1.40-10.30；P=0.0087]和年龄（OR 1.06，95%CI 1.01-1.11；P=0.012），PNQ（运动）评估的周围神经病。总之，吸烟史、BMI 和年龄被确定为纳武利尤单抗联合紫杉醇诱导的周围神经病变发展的显著预测因素。
