Gehr Nina Lykkegaard, Timm Signe, Bennedsgaard Kristine, Grosen Kasper, Jakobsen Erik, Jensen Anders Bonde, Rønlev Jeanette Dupont, Knoop Ann Søegaard, Finnerup Nanna B, Ventzel Lise
Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Denmark; Department of Oncology, University Hospital of Southern Denmark, Vejle, Denmark.
Department of Oncology, University Hospital of Southern Denmark, Vejle, Denmark; Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Denmark.
Breast. 2025 Apr;80:104424. doi: 10.1016/j.breast.2025.104424. Epub 2025 Feb 16.
Chemotherapy-induced peripheral neuropathy (CIPN) is a concerning late effect of taxane treatment. This study aimed to explore and compare long-term symptoms and consequences of CIPN after docetaxel and paclitaxel treatment. Patients with breast cancer who had followed Danish recommended adjuvant docetaxel or paclitaxel treatment regimens completed an online questionnaire 2-3 years after treatment. The questionnaire comprised the Michigan Neuropathy Screen Instrument, the European Organization for Research and Treatment of Cancer (EORTC) QLQ-CIPN20, EORTC QLQ C30, and CIPN-specific symptoms. Painful CIPN was assessed using the Douleur Neuropathique 4 Questions. Questionnaires from 411 patients (docetaxel: 192, paclitaxel: 219) were analyzed. No significant difference in the prevalence of possible CIPN between the two groups was observed (docetaxel: 48.4 % [93/192] vs. paclitaxel: 45.2 % [99/219]; 95 % CI: 6.4 - 12.9, p = 0.51). However, the EORTC-QLQ-CIPN20 sum score was higher in the docetaxel group (difference: 3.0; 95 % CI: 0.0-6.1, p = 0.05). Among patients with reported CIPN symptoms, significantly more in the docetaxel group reported painful CIPN (docetaxel: 53.8 % [50/93] than in the paclitaxel group: 34.3 % [34/99]; p = 0.01). Quality of life scores from the EORCT-QLQ-C30 questionnaire were significantly lower in those with possible CIPN than in those without and lower in patients with painful possible CIPN than in those with painless CIPN. Docetaxel caused more severe and painful CIPN symptoms than paclitaxel. These findings are highly relevant, as docetaxel remains a crucial component of cancer treatments.
化疗引起的周围神经病变（CIPN）是紫杉烷类药物治疗令人担忧的晚期效应。本研究旨在探讨和比较多西他赛与紫杉醇治疗后CIPN的长期症状及后果。接受丹麦推荐的辅助多西他赛或紫杉醇治疗方案的乳腺癌患者在治疗后2至3年完成了一份在线问卷。问卷包括密歇根神经病变筛查工具、欧洲癌症研究与治疗组织（EORTC）QLQ - CIPN20、EORTC QLQ C30以及CIPN特异性症状。使用神经病理性疼痛4问题评估疼痛性CIPN。对411例患者（多西他赛组：192例，紫杉醇组：219例）的问卷进行了分析。两组间可能发生CIPN的患病率无显著差异（多西他赛组：48.4% [93/192]，紫杉醇组：45.2% [99/219]；95%CI：6.4 - 12.9，p = 0.51）。然而，多西他赛组的EORTC - QLQ - CIPN20总分更高（差值：3.0；95%CI：0.0 - 6.1，p = 0.05）。在报告有CIPN症状的患者中，多西他赛组报告疼痛性CIPN的患者显著多于紫杉醇组（多西他赛组：53.8% [50/93]，紫杉醇组：34.3% [34/99]；p = 0.01）。EORCT - QLQ - C30问卷的生活质量得分在可能发生CIPN的患者中显著低于未发生者，在疼痛性可能发生CIPN的患者中低于无痛性CIPN患者。多西他赛比紫杉醇引起更严重和疼痛的CIPN症状。这些发现具有高度相关性，因为多西他赛仍是癌症治疗的关键组成部分。
