Medical Oncology Unit, University Hospital and University of Cagliari, 09042, Cagliari, Italy.
Department of Medical Sciences and Public Health, University of Cagliari, 09042, Cagliari, Italy.
Support Care Cancer. 2024 Oct 8;32(10):709. doi: 10.1007/s00520-024-08908-2.
Breast cancer is the most diagnosed tumor and a leading cause of cancer death in women worldwide. Taxanes are the most used chemotherapeutic agents and are strictly connected to neurotoxicity. Taxane-induced neuropathy (TIN) significantly impacts patients' quality of life (QOL). Early identification and management of TIN could improve preventive strategies to preserve patients' QOL during and after breast cancer treatment.
This prospective, observational study aimed to evaluate the taxane-induced neuropathy (TIN) in early breast cancer patients treated with weekly paclitaxel at an earlier stage and identify any correlation between TIN and QOL.
Data from stage I-III breast cancer patients treated with taxane-based therapy between 2018 and 2022 were collected at the Medical Oncology Unit of the University Hospital of Cagliari. Peripheral neuropathy was evaluated using the NCI-CTCAE scale (National Cancer Institute, Common Terminology Criteria for Adverse Events) at every drug administration. In contrast, QOL was assessed using EORTC QLC-CIPN20 and FACT-Taxane questionnaire at baseline (T0), after 4 weeks (T1) and 12 (T2) weeks of treatment. Statistical analysis was performed to evaluate the correlation between neurotoxicity and QOL.
Neurotoxicity incidence peaked at the third, fourth, and sixth week of treatment, with patients reporting grade 1 and 2 neurotoxicity. Simultaneously with increasing doses of paclitaxel, significant differences in QOL were observed in early treatment cycles relating to TIN presentation. Patients with higher neurotoxicity grades reported lower QOL scores.
Despite the absence of effective treatments to prevent paclitaxel-induced neurotoxicity, symptoms are managed through dosage reduction, delay, or treatment interruption. Future research should focus on identifying neuroprotective measures to avoid an irreversible decline in the quality of life for breast cancer survivors.
乳腺癌是全球最常见的肿瘤，也是女性癌症死亡的主要原因。紫杉烷类药物是最常用的化疗药物，与神经毒性密切相关。紫杉烷类药物引起的周围神经病变（TIN）显著影响患者的生活质量（QOL）。早期识别和管理 TIN 可以改善预防策略，以在乳腺癌治疗期间和之后保留患者的 QOL。
本前瞻性、观察性研究旨在评估早期接受每周紫杉醇治疗的早期乳腺癌患者的 TIN，并确定 TIN 与 QOL 之间的任何相关性。
收集了 2018 年至 2022 年期间在卡利亚里大学医院肿瘤内科接受紫杉烷类药物治疗的 I-III 期乳腺癌患者的数据。在每次给药时使用 NCI-CTCAE 量表（美国国家癌症研究所，不良事件通用术语标准）评估周围神经病变。相反，在治疗开始时（T0）、4 周后（T1）和 12 周后（T2）使用 EORTC QLC-CIPN20 和 FACT-Taxane 问卷评估 QOL。进行统计分析以评估神经毒性与 QOL 之间的相关性。
神经毒性的发生率在治疗的第三、第四和第六周达到高峰，患者报告了 1 级和 2 级神经毒性。随着紫杉醇剂量的增加，在早期治疗周期中，与 TIN 表现相关的 QOL 出现显著差异。神经毒性等级较高的患者报告的 QOL 评分较低。
尽管没有有效的治疗方法可以预防紫杉醇引起的神经毒性，但通过减少剂量、延迟或中断治疗来治疗症状。未来的研究应侧重于确定神经保护措施，以避免乳腺癌幸存者生活质量的不可逆转下降。
