文獻回顧乳癌婦女接受紫杉醇治療引發周邊神經病變之現況及其評估工具

Taxane-induced Peripheral Neuropathy and Its Assessment Tool in Women with Breast Cancer: A Literature Review

鄭有妏(You-Wun Jheng) ； 王雅容(Ya-Jung Wang)

《腫瘤護理雜誌》 16卷1期 (2016/06) Pp. 7-14

https://doi.org/10.3966/168395442016061601002

摘要

紫杉醇引發周邊神經病變（taxane-induced peripheral neuropathy, TIPN）是乳癌婦女接受紫杉醇治療後最常見且嚴重的副作用之一，其被形容為對稱性「末梢枯死」現象，這意味著症狀最先影響其雙腳趾或手指，輕者有末端肢體感覺異常，重者則出現運動或自主神經症狀，甚至干擾個案日常活動及降低生活品質，故護理人員應正視此問題。本文旨在以文獻回顧方式，論述紫杉醇引發周邊神經病變之病生理機轉、臨床表徵、相關因素與主客觀評估工具，期望可協助護理人員了解此概念，作為臨床照護的參考依據。

關鍵字

化學治療 ； 乳癌婦女 ； 周邊神經病變 ； 紫杉醇

並列摘要

Taxane-induced peripheral neuropathy (TIPN) is one of the common but serious adverse events occurring in breast cancer patients receiving taxane chemotherapy. TIPN is generally described as a symmetrical “dying-back” phenomenon, meaning it affects the toes or fingertips first. The mild symptom is paresthesia of the extremities and the severe neuropathy occurs in the motor or autonomic systems to sometimes even interfere with the daily activities and reduce patient's quality of life. Therefore, nurses should pay more attention to this issue. This article aims to review the pathophysiologic mechanisms, clinical manifestations, TIPN related factors, and assessment tools including both subjective and objective ones. The purposes of this literature review are to help nurses identify TIPN and to provide reference for clinical care.

並列關鍵字

chemotherapy ； female breast cancer ； peripheral neuropathy ； taxanes

參考文獻

Tofthagen, C. (2010). Patient perceptions associated with chemotherapy-induced peripheral neuropathy. Clinical Journal of Oncology Nursing, 14(3), E22-E28. doi: 10.1188/10.CJON.E22-E28

Tofthagen, C., Overcash, J., & Kip, K. (2012). Falls in persons with chemotherapy-induced peripheral neuropathy. Supportive Care in Cancer, 20(3), 583-589. doi: 10.1007/s00520-011-1127-7

Argyriou, A. A., Koltzenburg, M., Polychronopoulos, P., Papapetropoulos, S., & Kalofonos, H. P. (2008). Peripheral nerve damage associated with administration of taxanes in patients with cancer. Critical Reviews in Oncology/Hematology, 66(3), 218-228. doi: 10.1016/j.critrevonc.2008.01.008

Armstrong, T., Almadrones, L., & Gilbert, M. R. (2005). Chemotherapy-induced peripheral neuropathy. Oncology Nursing Forum, 32(2), 305-311. doi: 10.1188/05.ONF.305-311

Bhatnagar, B., Gilmore, S., Goloubeva, O., Pelser, C., Medeiros, M., Chumsri, S., ... Bao, T. (2014). 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. Springerplus, 3(366), 1-6. doi: 10.1186/2193-1801-3-366