Chemotherapy dose reduction due to chemotherapy induced peripheral neuropathy in breast cancer patients receiving chemotherapy in the neoadjuvant or adjuvant settings: a single-center experience
Chemotherapy dose reduction due to chemotherapy induced peripheral neuropathy in breast cancer patients receiving chemotherapy in the neoadjuvant or adjuvant settings: a single-center experience
复制标题
DOI：
10.1186/2193-1801-3-366
复制
发表时间：
2014-07-16
期刊：
影响因子：
--
通讯作者：
Bao, Ting
中科院分区：
文献类型：
--
作者：
Bhatnagar, Bhavana;Gilmore, Steven;Bao, Ting
目的：紫杉烷类药物是早期和晚期乳腺癌及其他常见恶性实体瘤的基础治疗药物；然而，化疗引起的周围神经病变（CIPN）的发展往往需要减少剂量，这可能会妨碍药物的有效性并损害生存结果，特别是在辅助治疗中使用时。关于CIPN引起的剂量减少的流行程度和严重程度的文献有限。我们试图确定在新辅助或辅助环境下接受紫杉烷化疗的早期乳腺癌患者中，cipn诱导的剂量减少的频率和严重程度。方法：我们对2008年1月至2011年12月在马里兰大学格林鲍姆癌症中心接受紫杉烷新辅助/辅助化疗的123例新诊断乳腺癌患者进行了回顾性的单机构乳腺癌临床图表回顾。结果：123例患者中有49例（40%;95% CI: 31-49%）需要减少剂量。这些患者中有21例（17%;95% CI: 11-25%）由于治疗期间发生的CIPN而减少了剂量。21例cipn诱导剂量减少患者的中位相对剂量强度（接受剂量/计划剂量）为73.4%（范围68.0-94.0%）。糖尿病患者出现紫杉烷诱导的剂量减少的风险更高（p值=0.01）。非裔美国患者和接受紫杉醇（而不是多西紫杉醇）治疗的患者发生cipn诱导的剂量减少的风险更高(p值为
Purpose: Taxanes are a cornerstone treatment in early and advanced stage breast cancer and in other common solid tumor malignancies; however, the development of chemotherapy induced peripheral neuropathy (CIPN) often necessitates dose-reduction, which may hamper the effectiveness of the drug and compromise survival outcomes especially when used in the adjuvant setting. Limited literature is available on the prevalence and severity of dose reduction due to CIPN. We sought to determine the frequency and severity of CIPN-induced dose reduction in early stage breast cancer patients who received taxane-based chemotherapy in the neoadjuvant or adjuvant settings.Methods: We conducted a retrospective single-institution breast cancer clinic chart review of 123 newly diagnosed breast cancer patients and treated with taxane-based neoadjuvant/ adjuvant chemotherapy at the University of Maryland Greenebaum Cancer Center between January 2008 and December 2011.Results: Forty-nine of 123 (40%; 95% CI: 31-49%) patients required dose reduction. Twenty-one (17%; 95% CI: 11-25%) of these patients were dose-reduced specifically due to CIPN that developed during treatment. The median relative dose intensity (received dose/planned dose) for the 21 CIPN-induced dose reduction patients was 73.4% (range, 68.0-94.0%). Patients with diabetes appeared to have a higher risk of taxane-induced dose reduction (p-value=0.01). African-American patients and those treated with paclitaxel (rather than docetaxel) experienced a higher-risk of CIPN-induced dose reduction (p-values are