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癌症患者神经病变评估中主观症状与神经生理学检查结果的前瞻性比较

A Prospective Comparison of Subjective Symptoms and Neurophysiological Findings in the Assessment of Neuropathy in Cancer Patients.

作者信息

Kleinveld Vera Elisabeth Adreana, Emmelheinz Miriam, Egle Daniel, Ritter Magdalena, Löscher Wolfgang N, Marth Christian, Horlings Corinne Gosewina Cornelia, Wanschitz Julia, Brunner Christine

机构信息

Department of Neurology, Medical University Innsbruck, 6020 Innsbruck, Austria.

Department of Obstetrics and Gynecology, Medical University Innsbruck, 6020 Innsbruck, Austria.

出版信息

Diagnostics (Basel). 2024 Dec 19;14(24):2861. doi: 10.3390/diagnostics14242861.

Abstract

Neurotoxic effects causing peripheral nerve damage have been reported for several chemotherapy agents. There is no established and standardized method to assess the presence of chemotherapy-induced peripheral neuropathy (CIPN). We compared patient-reported CIPN symptoms to neurophysiological findings and neurological assessments in patients receiving taxane-based chemotherapy. Patients scheduled to receive taxane-based chemotherapy for the treatment of gynecologic cancer were included and prospectively followed for up to 9 months after chemotherapy discontinuation, between May 2020 and January 2023. Patient-reported symptoms, using the EORTC-QLQ-CIPN20 questionnaire, and nerve conduction studies (NCSs) were performed at baseline, halfway through the treatment cycle, at the end of the treatment, 3 months after treatment, and 6-9 months after treatment. A total of 149 patients were included. Overall, 47.0% of patients reported symptoms compatible with CIPN at any of the follow-ups. Subjective symptoms did not correlate with nerve conduction studies. SNAP amplitudes at baseline were lower in patients who developed CIPN compared to the group without CIPN. The overall diagnostic accuracy of electrophysiological parameters as a marker for CIPN was low.

摘要

已有报道称,几种化疗药物会产生导致周围神经损伤的神经毒性作用。目前尚无评估化疗引起的周围神经病变(CIPN)的既定标准化方法。我们将接受紫杉烷类化疗患者报告的CIPN症状与神经生理学检查结果及神经学评估进行了比较。纳入计划接受紫杉烷类化疗治疗妇科癌症的患者,并在2020年5月至2023年1月期间化疗结束后进行长达9个月的前瞻性随访。在基线、治疗周期中途、治疗结束时、治疗后3个月以及治疗后6 - 9个月,使用欧洲癌症研究与治疗组织生活质量问卷CIPN20(EORTC-QLQ-CIPN20)收集患者报告的症状,并进行神经传导研究(NCS)。共纳入149例患者。总体而言,47.0%的患者在任何一次随访中报告了与CIPN相符的症状。主观症状与神经传导研究结果不相关。与未发生CIPN的组相比,发生CIPN的患者基线时感觉神经动作电位(SNAP)波幅较低。电生理参数作为CIPN标志物的总体诊断准确性较低。

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