Chemotherapy-induced peripheral neuropathy as a predictor of neuropathic pain in breast cancer patients previously treated with paclitaxel.
Chemotherapy-induced peripheral neuropathy as a predictor of neuropathic pain in breast cancer patients previously treated with paclitaxel.
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DOI：
10.1016/j.jpain.2009.04.006
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发表时间：
2009-11
期刊：
影响因子：
--
通讯作者：
Shete S
中科院分区：
文献类型：
--
作者：
Reyes-Gibby CC;Morrow PK;Buzdar A;Shete S
对于相当数量的癌症患者来说，神经病理性疼痛(NP)仍然难以控制。化疗所致周围神经病变(CIPN)被认为是NP发展的初始阶段。为了评估CIPN(定义为国家癌症研究所共同毒性标准2级或更高)是否与NP相关，我们对参与紫杉醇临床试验的乳腺癌患者进行了调查。在430名潜在受访者中，有240人回复了调查。结果显示，在紫杉醇治疗期间，出现了CIPN。随访调查数据显示，27%的CIPN患者随后被诊断为NP。Logistic回归分析显示，那些经历过CIPN的人发生NP的可能性是后者的3倍(95%可信区间=1.2-7.2p<；0.001)，并坚持多因素Logistic模型。此外，NP患者报告的就诊次数是没有NP的患者的两倍(p=0.02)，并且服用了更多的处方(50%比19%；p=0.001)和止痛药(62.5%比45%；p=0.08)。这项研究的结果证实了CIPN是NP的预测因子，这表明接受紫杉醇治疗的幸存者在治疗之外应该定期监测NP。
Neuropathic pain (NP) remains difficult to control for a significant number of patients with cancer. Chemotherapy-induced peripheral neuropathy (CIPN) has been postulated as an initial stage in the development of NP. To assess whether CIPN (defined as National Cancer Institute Common Toxicity Criteria grade 2 or higher) was associated with NP, we conducted a survey of breast cancer patients who had participated in clinical trials of paclitaxel. Of the 430 potential respondents, 240 responded to the survey. Results showed that 64% experienced CIPN during paclitaxel treatment. Follow-up survey data revealed that 27% of those with CIPN were subsequently diagnosed with NP. Logistic regression analyses showed that those who had experienced CIPN were 3 times more likely to develop NP (95% confidence interval=1.2-7.2; p<0.001), which persisted in the multivariate logistic model. In addition, NP patients reported twice as many visits to their health care provider (p=0.02) and had taken more prescription (50% versus 19%; p=0.001) and over-the-counter medications (62.5% versus 45%; p=0.08) for pain than those without NP. The results of this study confirm that CIPN is a predictor of NP, suggesting that survivors treated with paclitaxel should be regularly monitored for NP beyond treatment.
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