Torii Yutaka, Naito Kana, Takagi Junichi, Yasue Akira, Tsukada Kazuhiko, Fujii Takuma, Nishizawa Haruki
Department of Obstetrics and Gynecology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan.
Department of Gynecology, Fujita Health University Okazaki Medical Center, Okazaki, Aichi, Japan.
Fujita Med J. 2025 Feb;11(1):11-19. doi: 10.20407/fmj.2024-013. Epub 2024 Oct 31.
Chemotherapy-induced peripheral neuropathy (CIPN), a frequently occurring adverse event associated with paclitaxel/carboplatin (TC) combination therapy, causes limb pain and markedly reduces the patient's quality of life. Since zinc has been reported to be associated with neuropathic pain, we investigated the relationship between CIPN due to TC therapy and serum zinc levels.
The study included 13 patients with gynecological cancer whose serum zinc levels were measured before and during TC therapy. CIPN was classified into severity grades based on the Common Terminology Criteria for Adverse Events v5.0. A retrospective analysis was conducted on the relationship between the serum zinc level before TC therapy (PreZn), the minimum serum zinc level measured during TC therapy (MinZn), the MinZn/PreZn ratio, the number of TC treatment cycles, and the maximum grade of CIPN (MaxG) using Pearson's correlation coefficient. Moreover, an analysis was also conducted on clinical factors influencing MaxG, as well as fluctuations in serum zinc levels and CIPN grades for each cycle of TC therapy.
A negative correlation was observed between the MinZn/PreZn ratio and MaxG (r=-0.557, p=0.048). The clinical factors influencing CIPN remained unclear, and the decrease in serum zinc levels and the aggravation of CIPN plateaued after the third cycle.
If a decrease in serum zinc levels during TC therapy is smaller than before therapy, it may imply the existence of a causal relationship that suppresses the aggravation of CIPN.
化疗引起的周围神经病变(CIPN)是与紫杉醇/卡铂(TC)联合治疗相关的常见不良事件,会导致肢体疼痛并显著降低患者的生活质量。由于有报道称锌与神经性疼痛有关,我们研究了TC治疗引起的CIPN与血清锌水平之间的关系。
该研究纳入了13例妇科癌症患者,在TC治疗前及治疗期间测量其血清锌水平。根据《不良事件通用术语标准》第5.0版将CIPN分为严重程度等级。使用Pearson相关系数对TC治疗前的血清锌水平(PreZn)、TC治疗期间测量的最低血清锌水平(MinZn)、MinZn/PreZn比值、TC治疗周期数以及CIPN的最高等级(MaxG)之间的关系进行回顾性分析。此外,还对影响MaxG的临床因素以及TC治疗每个周期的血清锌水平波动和CIPN等级进行了分析。
观察到MinZn/PreZn比值与MaxG之间存在负相关(r = -0.557,p = 0.048)。影响CIPN 的临床因素仍不明确,血清锌水平的下降和CIPN的加重在第三个周期后趋于平稳。
如果TC治疗期间血清锌水平的下降幅度小于治疗前,这可能意味着存在抑制CIPN加重的因果关系。