Argyriou Andreas A, Velasco Roser, Kalofonou Foteini, Litsardopoulos Pantelis, Alemany Montse, Rikos Dimitrios, Kalofonos Haralabos P, Bruna Jordi
Neurological Department, "Agios Andreas" General Hospital of Patras, Patras, 26335, Greece.
Hospital UnivNeuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO L'Hospitalet, IDIBELLersitari de Bellvitge-ICO L'Hospitalet, IDIBELL, Barcelona, Spain.
BMC Cancer. 2025 Jul 21;25(1):1193. doi: 10.1186/s12885-025-14579-x.
OBJECTIVE: To determine whether the clinical phenotype of chemotherapy-induced neuropathic pain (CINP) varies based on the gender and age of patients. METHODS: Retrospective, file-based analysis of cancer patients who received any conventional standard of care chemotherapy and were referred to assess the extent of painful chemotherapy-induced peripheral neurotoxicity (CIPN). A Propensity Score Matching Analysis (PSMA) was conducted to create balanced cohorts; accounting for variables that could impact the incidence and severity of CINP in CIPN patients. A total of 205 males and 295 females were initially included, and after PSMA, 191 patients of each gender were equally matched; totaling 382 patients. These patients were divided according to their age to those aged ≤65 years (group I, n=216) and patients aged ≥66 years (group II, n=166). CINP was assessed using the pain intensity numerical rating scale (PI-NRS) and the Douleur Neuropathique-4 questionnaire (DN4). The severity of CIPN was graded with Total Neuropathy Score-clinical (TNSc®). RESULTS: The incidence of CINP was similar between males and females (27.2% vs. 27.7%; p = 1). The same applied for the DN4 scorings at CINP onset (median 7; p = 0.9). The severity of CINP at the end of chemotherapy, according to PI-NRS, was 7 (range:6-9) for males vs. 7 (range: 5-8) for females (p = 0.09), while at 3 months post-chemotherapy the PI-NRS scorings were comparable (p = 0.56). However, males tended towards higher rates of severe CINP (PI-NRS ≥ 7) [males: 59.5%, females: 40.5%; p = 0.1], compared to female patients, despite having lower CIPN severities, according to TNSc scoring. No statistically significant differences were observed in the incidence (25% vs. 30.7%; p = 0.214) and severity (mean PI-NRS difference p = 0.584) of CINP between age groups. Older male patients presented a higher likelihood (OR: 1.08; 95CI: 1.01-1.16; p = 0.027) of severe pain (PI-NRS ≥ 7) at the end of chemotherapy, compared to their younger counterparts. CONCLUSION: There were no significant differences found between the occurrence and severity of CINP, based on gender or age. However, older men had more severe pain raters (PI-NRS), while scoring lower in TNSc® severities.
目的：确定化疗诱导的神经性疼痛（CINP）的临床表型是否因患者的性别和年龄而异。 方法：对接受任何常规标准护理化疗并被转诊以评估疼痛性化疗诱导的周围神经毒性（CIPN）程度的癌症患者进行基于档案的回顾性分析。进行倾向得分匹配分析（PSMA）以创建平衡队列；考虑可能影响CIPN患者中CINP发生率和严重程度的变量。最初纳入了205名男性和295名女性，经过PSMA后，每种性别的191名患者进行了同等匹配；总共382名患者。这些患者根据年龄分为≤65岁组（I组，n = 216）和≥66岁组（II组，n = 166）。使用疼痛强度数字评定量表（PI-NRS）和神经病理性疼痛4问卷（DN4）评估CINP。CIPN的严重程度用临床总神经病变评分（TNSc®）分级。 结果：男性和女性之间CINP的发生率相似（27.2%对27.7%；p = 1）。CINP发作时的DN4评分情况相同（中位数为7；p = 0.9）。根据PI-NRS，化疗结束时男性CINP的严重程度为7（范围：6 - 9），女性为7（范围：5 - 8）（p = 0.09），而化疗后3个月时PI-NRS评分相当（p = 0.56）。然而，尽管根据TNSc评分男性的CIPN严重程度较低，但与女性患者相比，男性严重CINP（PI-NRS≥7）的发生率更高[男性：59.5%，女性：40.5%；p = 0.1]。各年龄组之间CINP的发生率（25%对30.7%；p = 0.214）和严重程度（平均PI-NRS差异p = 0.584）未观察到统计学上的显著差异。与年轻男性患者相比，老年男性患者在化疗结束时出现严重疼痛（PI-NRS≥7）的可能性更高（OR：1.08；95CI：1.01 - 1.16；p = 0.027）。 结论：基于性别或年龄，CINP的发生和严重程度未发现显著差异。然而，老年男性的疼痛评分（PI-NRS）更高，而在TNSc®严重程度评分中更低。
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