Clinical Analysis Of Chemotherapy-induced Peripheral Neuropathy

Background:In recent years,the incidence of malignant tumor is increasing year by year,which seriously endangers human life and health.Chemotherapy is one of the main anti-tumor treatment methods,and the application of chemotherapeutic drugs is becoming more and more widespread.Chemotherapy-induced peripheral neuropathy(CIPN)is a drug dose-limiting adverse reaction that occurs during the chemotherapy of cancer patients.The main manifestations of CIPN are the abnormal sensation and movement,the symptoms of weakness,numbness,tingling,burning,wearing socks or glove abnormality,and occasionally the symptoms of motor nerve,sympathetic and cranial neuropathy,and the symptoms may last for several months or even years.CIPN seriously affects the quality of life of the cancer patients,causes the patients to reduce the dose of chemotherapeutic drugs,shorten the chemotherapy cycle and even stop the drug.Therefore,it may increase the risk of disease recurrence and reduce the survival rate of the patients.At present,when medical workers have antitumor treatment for cancer patients,their attention is focused more on the antitumor treatment itself and relatively neglects CIPN,and the attention to CIPN will be reduced once the antitumor treatment is completed.In addition,the current mechanism of CIPN has not been clarified,the lack of effective methods of prevention and control,coupled with the lack of full and comprehensive understanding of the current CIPN,resulting in the failure of the CIPN to be treatedeffectively.Objective: In this paper,the incidence of CIPN,the main effects of drugs,clinical manifestations,clinical manifestations and drug dose correlation were arranged and analyzed in order to improve the understanding of the disease and the level of diagnosis and treatment.Methods:The clinical data of 35 patients with malignant tumor chemotherapy were reviewed and analyzed from November 2017 to May 2018 in the oncology department of the Second Affiliated Hospital of Nanjing Medical University.Results:1.Among the 35 patients in the study,23 were platinum group chemotherapy,2 were paclitaxel chemotherapy,and 10 were paclitaxel plus platinum chemotherapy.In 35 cases of chemotherapy,27 patients developed peripheral neurotoxic lesions after chemotherapy.2.The quality of life of patients with peripheral neuropathy after chemotherapy was significantly lower than that of peripheral neuropathy(P < 0.001).3.In patients with peripheral neuropathy after chemotherapy,the main clinical manifestations of CIPN clinical manifestations of platinum chemotherapeutic agents were loss of end sensation and loss of distal end numbness and weakness in the upper and lower extremities.Chemotherapy of paclitaxel mainly showed glove,sock like numbness,burning sensation,ant feeling,deep tendon reflex disappearing.The symptoms of nerve numbness appeared quickly at the early stage of drug use,and the part could be recovered after the end of drug use.10 cases of platinum combined paclitaxel.The main manifestations were weakness,numbness,burning sensation,wearing socks or glove-like symptoms,and 2cases were characterized by fast onset sensation and motor nerve disorder in the period of medication,affecting daily walking.4.With the increase of treatment course and dosage of tumor patients,the symptoms of CIPN gradually increase.The cumulative dose of oxaliplatin was up to 410-780mg/m2,800-1000mg/m2 and > 1000mg/m2,and compared with the cumulative dose of 120-400mg/m2,the incidence of oxaliplatin increased significantly.With cumulative dose increasing,CIPN neurotoxicity gradually increased and symptoms gradually increased(P < 0.05).Conclusion:1.The incidence of CIPN is high,which seriously affects the quality of life of tumor patients.2.CIPN and other primary platinum drugs(such as oxaliplatin)and paclitaxel(such as paclitaxel)and other first-line chemotherapy drugs.3.CIPN clinical manifestations of the main manifestations of the sensation and movement abnormalities,numbness of the limbs,weakness,tingling,burning feeling,wearing socks or glove like abnormal symptoms,occasionally also manifested as motor nerve symptoms 4.The clinical manifestations of peripheral neuropathy in CIPN patients are cumulative dose dependent.