白蛋白结合型紫杉醇致妇科恶性肿瘤患者周围神经病变的临床和相关因素分析

Analysis of Clinical and Related Factors on Albumin-bound Taxol Chemotherapy-induced Peripheral Neuropathy in Patients with Gynecological Malignant Tumor

目的:分析白蛋白结合型紫杉醇化疗后妇科癌症患者发生周围神经病变的临床影响因素,为化疗致周围神经病变(CIPN)的早期诊断与预测提供参考。方法:选取本院应用白蛋白结合型紫杉醇化疗的妇科恶性肿瘤患者180例,统计分析化疗后不同年龄、肿瘤类型、合并基础疾病、化疗剂量、以及联合应用有神经毒性药物的患者CIPN发生率。结果:180例患者CIPN发生率为42.78%,Logisfic回归显示危险因素(OR,95%CI)包括年龄>65岁1.028(1.005~1.052),合并糖尿病9.023(1.321~11.643),单次剂量为[2.563(1.067~6.164)]和/或累积剂量高[5.812(1.916~9.692)和7.116(1.602~13.188)],联合其他具有神经毒性药物1.455(1.157~1.768)。结论:妇科癌症患者接受白蛋白结合型紫杉醇化疗后,尤其应关注合并糖尿病、单次剂量和/或累积剂量高所致CIPN风险。

Objective:To analyze the clinical influencing factors for the early diagnosis and prediction of chemotherapy-induced peripheral neuropathy(CIPN)in patients with gynecological malignant tumor after albumin-bound taxol chemotherapy.Methods:A total of 180 gynecological malignant tumor patients who received albumin-bound taxol chemotherapy in Xuzhou NO.1 People's Hospita were selected.The incidence of CIPN in patients with different ages,tumor types,combined underlying diseases,chemotherapy doses and combined neurotoxic drugs after chemotherapy was analyzed.ResuIts:The incidence of CIPN in the 180 patients was 42.78%.Multivariate logistic regression analysis showed that age,diabetes,combined use of neurotoxic drugs,single dose of 260 mg·m-2,and cumulative dose of 601-900 and 901-1200 mg·m-2 were independent risk factors for CIPN(OR values were 1.028,9.023,1.445,2.563,5.812 and 7.116,respectively).Conclusions:Patients with diabetes,high single and/or cumulative dose should be paid more attention to avoid raising CIPN.