Rades Dirk, Bartscht Tobias, Rody Achim, Ballegaard Martin
Department of Radiation Oncology, University of Lübeck, 23562 Lübeck, Germany.
Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Lübeck Campus, 23538 Lübeck, Germany.
J Pers Med. 2025 Jun 13;15(6):248. doi: 10.3390/jpm15060248.
Many patients assigned to adjuvant radiotherapy for non-metastatic breast cancer already received taxane-based chemotherapy, which can cause peripheral neuropathy (PNP). This study investigated potential associations between moderate-to-severe or mild PNP and distress. Ninety-eight breast cancer patients who received taxane-based chemotherapy and completed the National Comprehensive Cancer Network Distress Thermometer were included in this retrospective study. The severity of PNP plus 17 factors were evaluated for associations with distress. Mean distress scores (higher scores representing higher levels of distress) were 6.17 (SD ± 2.41) in patients with moderate-to-severe PNP, 4.21 (SD ± 2.54) in patients with mild PNP and 4.04 (SD ± 2.24) in patients without PNP. On univariable analyses, higher distress scores were significantly associated with moderate-to-severe PNP (vs. mild or no PNP, < 0.001), Karnofsky performance score ≤ 80 ( = 0.001), history of autoimmune disease ( = 0.035), and hypertension ( = 0.002). Trends were found for age ≥65 years ( = 0.056), type of chemotherapy ( = 0.078), and beta-blocker medication ( = 0.072). On multivariable analysis, moderate-to-severe PNP ( = 0.036), Karnofsky performance score ≤ 80 ( = 0.013), and hypertension ( = 0.045) were significant. : Since moderate-to-severe chemotherapy-induced PNP was associated with a significantly higher level of distress when compared to mild or nor PNP, these patients should be offered early psychological support and personalized monitoring.
许多被分配接受非转移性乳腺癌辅助放疗的患者已经接受了基于紫杉烷的化疗，这可能会导致周围神经病变（PNP）。本研究调查了中度至重度或轻度PNP与痛苦之间的潜在关联。这项回顾性研究纳入了98名接受基于紫杉烷化疗并完成了美国国立综合癌症网络痛苦温度计调查的乳腺癌患者。评估了PNP的严重程度以及17个因素与痛苦的关联。中度至重度PNP患者的平均痛苦评分（分数越高表示痛苦程度越高）为6.17（标准差±2.41），轻度PNP患者为4.21（标准差±2.54），无PNP患者为4.04（标准差±2.24）。在单变量分析中，较高的痛苦评分与中度至重度PNP（与轻度或无PNP相比，<0.001）、卡诺夫斯基表现评分≤80（=0.001）、自身免疫性疾病史（=0.035）和高血压（=0.002）显著相关。发现年龄≥65岁（=0.056）、化疗类型（=0.078）和β受体阻滞剂用药（=0.072）存在趋势。在多变量分析中，中度至重度PNP（=0.036）、卡诺夫斯基表现评分≤80（=0.013）和高血压（=0.045）具有显著性。结论：由于与轻度或无PNP相比，中度至重度化疗诱导的PNP与显著更高水平的痛苦相关，这些患者应获得早期心理支持和个性化监测。
