Association between patient reported outcomes and quantitative sensory tests for measuring long-term neurotoxicity in breast cancer survivors treated with adjuvant paclitaxel chemotherapy
Association between patient reported outcomes and quantitative sensory tests for measuring long-term neurotoxicity in breast cancer survivors treated with adjuvant paclitaxel chemotherapy
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DOI：
10.1007/s10549-010-1278-0
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发表时间：
2011-02-01
影响因子：
3.8
通讯作者：
Crew, Katherine D.
中科院分区：
文献类型：
--
作者：
Hershman, Dawn L.;Weimer, Louis H.;Crew, Katherine D.
神经毒性是紫杉烷治疗中常见的副作用。治疗后长期神经毒性的发生率和严重程度尚不清楚。作者对50例连续的I-III期BC患者进行了横断面研究，这些患者在6个月和2年内完成了辅助紫杉烷治疗，并对50名开始紫杉烷治疗的女性进行了前瞻性研究。横断面研究中的患者进行了一次性评估，而前瞻性研究中的患者在基线、治疗后以及完成治疗后3、6、9和12个月进行了评估。评估包括触觉感知和振动阈值的定量感官测试（QST）和FACT- gog Neurotaxane （FACT/GOG-Ntx）。在横断面研究中，81%的女性报告在过去一周出现手脚麻木和/或不适的症状。27%的手部和25%的足部患者报告有严重症状。在横截面分析中，手部麻木/不适与手部振动QST相关。在前瞻性研究中，FACT/GOG-Ntx的平均评分从治疗后的37.5分下降到28.7分（P = 0.0002），并且在治疗后12个月保持在较低水平。手/足麻木/不适的变化与振动阈值的变化显著相关。触摸感知没有明显变化。在紫杉烷治疗后2年内，手脚麻木和不适是常见的，并且与振动阈值有关。FACT/GOG-Ntx是临床试验评估预防BC幸存者长期神经毒性方法的适当结果测量。
Neurotoxicity is a common side-effect during taxane therapy. The prevalence and severity of long-term neurotoxicity following therapy is unknown. The authors conducted a cross-sectional study of 50 consecutive patients with stage I-III BC, who were within 6 months and 2 years of completing adjuvant taxane therapy and a prospective study of 50 women initiating taxane therapy. Patients in the cross-sectional study underwent a one-time evaluation while patients in the prospective study underwent evaluation at baseline, following therapy, and 3, 6, 9, and 12 months after completing therapy. Assessments included quantitative sensory testing (QST) for touch perception and vibration threshold and the FACT-GOG Neurotaxane (FACT/GOG-Ntx). For the cross-sectional study, 81% of the women reported symptoms of numbness and/or discomfort in the hands and/or feet in the past week. Severe symptoms were reported in 27% of patients for the hands and 25% for the feet. In the cross-sectional analysis, hand numbness/discomfort correlated with hand vibration QST. In the prospective study, the mean scores on the FACT/GOG-Ntx decreased from 37.5 to 28.7 post-treatment (P = 0.0002), and remained low 12 months after treatment. The changes in hand/foot numbness/discomfort were significantly associated with change in vibration threshold. No significant change was seen in touch perception. Numbness and discomfort in the hands and feet are common for up to 2 years following taxane therapy, and are associated with vibration threshold. The FACT/GOG-Ntx is an appropriate outcome measure for clinical trials evaluating ways to prevent long-term neurotoxicity in BC survivors.