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在底特律癌症幸存者研究(ROCS)队列中,化疗引起的周围神经病。

Chemotherapy-induced peripheral neuropathy in the detroit research on cancer survivors (ROCS) cohort.

机构信息

Ascension St. Vincent Hospital, Indianapolis, IN, 46260, USA.

Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, 48201, USA.

出版信息

Cancer Causes Control. 2023 May;34(5):459-468. doi: 10.1007/s10552-023-01676-0. Epub 2023 Mar 19.

Abstract

PURPOSE

Improved life expectancy has increased the likelihood for long-term complications from chemotherapy among cancer survivors. One burdensome complication is chemotherapy-induced peripheral neuropathy (CIPN). We evaluated rates of CIPN outcomes in the Detroit Research on Cancer Survivorship (ROCS) cohort.

METHODS

The population included 1,034 African American (AA) survivors who received chemotherapy for breast, colorectal, lung or prostate cancer. CIPN prevalence was based on initial occurrence of worsening of self-reported pain, numbness or tingling after chemotherapy. Current CIPN included symptoms still present at the time of the survey, and persistent CIPN symptoms were present 12 or more months post-chemotherapy. CIPN severity was ranked as mild, moderate or severe. Logistic regression was utilized to evaluate sociodemographic and clinical factors associated with the various categories of CIPN.

RESULTS

CIPN prevalence was 68%, with 53% current and 52% persistent. The symptom severity distribution based on prevalent CIPN included 32.2% mild, 30.8% moderate, and 36.9% severe. Factors associated with prevalent CIPN (odds ratio, 95% confidence interval) included primary cancer site (breast: 3.88, 2.02-7.46); and (colorectal: 5.37, 2.69-10.73), lower risk for older age at diagnosis (0.66, 0.53-0.83) and divorced/separated marital status (2.13, 1.42-3.21). Current CIPN was in addition, associated with more advanced stage disease trend (1.34, 1.08-1.66) and greater number of co-morbid medical conditions trend (1.23, 1.09-1.40), as was persistent CIPN. Severity of prevalent CIPN was associated with history of arthritis (1.55, 1.06-2.26) and severity of persistent CIPN with higher BMI (1.58, 1.07-2.35).

CONCLUSIONS

CIPN is a common and persistent complication in AA cancer survivors. Further research is needed to improve our understanding of CIPN predictors in all groups of cancer survivors.

摘要

目的

预期寿命的延长增加了癌症幸存者接受化疗后出现长期并发症的可能性。化疗引起的周围神经病变(CIPN)是一种负担沉重的并发症。我们评估了底特律癌症生存研究(ROCS)队列中 CIPN 结局的发生率。

方法

该人群包括 1034 名接受乳腺癌、结直肠癌、肺癌或前列腺癌化疗的非裔美国人(AA)幸存者。CIPN 的患病率是基于化疗后自我报告的疼痛、麻木或刺痛恶化的最初发生情况。当前 CIPN 包括在调查时仍存在的症状,持续 CIPN 症状在化疗后 12 个月或更长时间存在。CIPN 严重程度分为轻度、中度或重度。使用逻辑回归评估与各种 CIPN 类别相关的社会人口统计学和临床因素。

结果

CIPN 的患病率为 68%,其中 53%为当前 CIPN,52%为持续性 CIPN。基于 CIPN 的患病率,症状严重程度分布包括 32.2%为轻度、30.8%为中度和 36.9%为重度。与 CIPN 患病率相关的因素(比值比,95%置信区间)包括原发癌部位(乳腺癌:3.88,2.02-7.46);(结直肠癌:5.37,2.69-10.73)、诊断时年龄较大的风险较低(0.66,0.53-0.83)和离婚/分居的婚姻状况(2.13,1.42-3.21)。此外,当前 CIPN 还与更晚期疾病趋势(1.34,1.08-1.66)和更多共病医疗状况趋势(1.23,1.09-1.40)相关,持续性 CIPN 也是如此。CIPN 的严重程度与关节炎病史相关(1.55,1.06-2.26),而持续性 CIPN 的严重程度与更高的 BMI 相关(1.58,1.07-2.35)。

结论

CIPN 是 AA 癌症幸存者常见且持续存在的并发症。需要进一步研究以提高我们对所有癌症幸存者 CIPN 预测因素的理解。

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Chemotherapy-Induced Peripheral Neuropathy: Mechanisms and Therapeutic Avenues.化疗诱导性周围神经病:发病机制与治疗策略。
Neurotherapeutics. 2021 Oct;18(4):2384-2396. doi: 10.1007/s13311-021-01142-2. Epub 2021 Oct 21.

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