A Questionnaire Survey of Physicians' Perspectives Regarding the Assessment of Chemotherapy-induced Peripheral Neuropathy in Patients with Breast Cancer
A Questionnaire Survey of Physicians' Perspectives Regarding the Assessment of Chemotherapy-induced Peripheral Neuropathy in Patients with Breast Cancer
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DOI：
10.1093/jjco/hyn100
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发表时间：
2008-11-01
影响因子：
2.4
通讯作者：
Hausheer, Frederick H.
中科院分区：
文献类型：
--
作者：
Kuroi, Katsumasa;Shimozuma, Kojiro;Hausheer, Frederick H.
目的：由于现在人们对将患者报告的结果测量纳入癌症临床试验越来越感兴趣，因此开发了基于患者的问卷，即患者神经毒性问卷（PNQ），以量化化疗引起的周围神经病变（CIPN）的症状和严重程度。本研究的目的是评估医生对 PNQ 的实用性和诊断价值的看法。方法：向参加乳腺癌辅助化疗 III 期随机试验（AC 随后紫杉烷与单独紫杉烷）的 61 名医生发送了一份调查问卷，该试验使用 PNQ 来评估 CIPN。结果：61 名医生中有 47 名 (77%) 做出了回应。大多数人认为神经感觉症状是 CIPN 的诊断标志，大多数人认为对日常生活活动 (ADL) 的干扰是调整治疗的明确理由。对于神经感觉障碍，大多数医生表示，D 级严重程度（干扰 ADL 的中度至重度症状）应导致治疗推迟，E 级严重程度（妨碍大多数 ADL 的严重症状）应导致治疗停止。同样，对于神经运动障碍，超过一半的医生回答说，C 级（不影响 ADL 的中度症状）、D 级和 E 级严重程度应分别导致剂量减少、治疗推迟和停止治疗。 84% 的医生表示使用 PNQ 有助于诊断和评估有 CIPN 风险的患者。结论：PNQ 似乎是 CIPN 的诊断和分级以及 CIPN 继发治疗修改的临床决策的有用工具。
Objective: Since there is now growing interest in the incorporation of patient-reported outcome measures in cancer clinical trials, a patient-based questionnaire, the Patient Neurotoxicity Questionnaire (PNQ) was developed to quantify the symptoms and severity of chemotherapy-induced peripheral neuropathy (CIPN). The aim of this study was to evaluate the physicians' perspectives regarding the utility and diagnostic value of PNQ.Methods: A questionnaire was sent to 61 physicians who participated in a Phase III randomized trial of adjuvant chemotherapy in breast cancer (AC followed by taxane versus taxane alone) that used the PNQ to assess CIPN.Results: Forty-seven out of 61 physicians (77%) responded. The majority considered neurosensory symptoms the diagnostic hallmark for CIPN and most regarded interference with activities of daily living (ADLs) as definite justification for treatment modifications. For neurosensory disturbance, the majority of physicians indicated that Grade D severity (moderate to severe symptoms interfering with ADLs) should result in treatment postponement and Grade E severity (severe symptoms preventing most ADLs) should result in treatment discontinuation. Similarly, for neuromotor disturbance, over half of the physicians replied that Grade C (moderate symptoms not interfering with ADLs), D and E severity should result in dose reduction, treatment postponement and treatment discontinuation, respectively. Eighty-four percentage of the physicians reported that the use of the PNQ was helpful in the diagnosis and assessment of patients at risk of CIPN. Conclusions: The PNQ appears to be a useful instrument for the diagnosis and grading of CIPN, as well as for clinical decision-making regarding treatment modifications secondary to CIPN.