Проспективная комплексная оценка химиоиндуцированной периферической нейропатии у пациенток с раком молочной железы

Abstract

Introduction. Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-dependent side effect of anticancer therapy that affects the patient’s quality of life. Currently, the problem of effective and reliable diagnostics for CIPN remains unresolved. Therefore, it is critically important to develop recommendations for a comprehensive assessment of peripheral neuropathy based on simple tests for vibration, tactile, pain sensitivity together with questionnaires. Aim. A prospective comprehensive assessment of the incidence and severity of CIPN using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) and the Patient Neurotoxicity Questionnaire (PNQ) in patients with breast cancer treated with taxanes. Materials and methods. Symptoms of CIPN were prospectively assessed in 60 patients using the PNQ, the NCI-CTCAE and the Eastern Cooperative Oncology Group (ECOG) Performance Status scores at baseline, 1 week after and 13 weeks after the start of chemotherapy. Results. The CIPN scores according to the PNQ were widely distributed among patients compared to the NCI-CTCAE scores for both sensory and motor neuropathy. There was a marked increase in symptoms of motor neuropathy in patients who were identified only on the basis of PNQ data. The PNQ was used to formally assess the impact of neuropathy on the patient’s activities of daily living. Conclusion. A comprehensive methodology based on a neurological examination together with the NCI-CTCAE and the PNQ will allow a more detailed assessment of the severity of СIPN, and in the future will provide an opportunity to develop a more effective patient management plan. The PNQ has shown itself to be a more sensitive tool compared to the NCI-STCAE, especially in assessing sensory neuropathy. Thus, it is reasonable to include patient-reported data in the evaluation of СIPN in order to provide a more accurate identification of the frequency and severity of neuropathy.