Nörotoksik Kemoterapi Alan Kadınlarda Periferal Nöropati Şiddeti ile Ağrı ve Yaşam Kalitesinin Belirlenmesi

Year 2026, Volume: 11 Issue: 1, 173 - 178, 28.01.2026

Filiz Ünal Toprak , Neşe Uysal

https://doi.org/10.61399/ikcusbfd.1599801

Abstract

Amaç: Bu çalışma, nörotoksik kemoterapi alan kadınlarda periferal nöropati şiddeti ile ağrı ve yaşam kalitesi düzeylerinin belirlenmesi amacıyla yapılmıştır.
Gereç ve Yöntem: Tanımlayıcı türdeki bu araştırmanın örneklemi Şubat-Ağustos 2023 tarihleri arasında Gülhane Eğitim ve Araştırma Hastanesi, Kemoterapi Ünitesinde nörotoksik kemoterapi ilaçlarından en az bir tanesini alan, en az 3 kür kemoterapi almış olan, grade 1 ve üzeri periferal nöropatisi olan, 18-65 yaş aralığında olan, Türkçe bilen, çalışmaya katılmayı kabul eden 152 kadın hastadan oluşmuştur. Araştırma verileri, tanıtıcı bilgi formu, ağrı ve nöropati değerlendirme formu, kanser hastalarının yaşam kalitesini değerlendirme formu ve kemoterapiye bağlı periferik nöropati değerlendirme formu kullanılarak toplanmıştır.
Bulgular: Çalışmamızda kemoterapiye bağlı periferal nöropatinin yaşam kalitesi olumsuz etkilediği, kadınların %76,65’inin ağrı semptomu yaşadığı, %77,6’sında grade 1 periferal nöropati görüldüğü belirlenmiştir. Grade 2 nöropatisi olan hastaların nöropati şiddetine göre yaşam kalitesi puanlarında fiziksel, rol ve emosyonel fonksiyon ortalama puanları daha düşüktür (p<0,05). Grade 2 nöropatisi olan hastaların semptom skalası alt boyutlarında bulantı, ağrı ve yorgunluk puanları daha yüksektir. Kemoterapiye bağlı periferik nöropati ölçeği alt boyutları değerlendirildiğinde, grade 2 nöropatisi olan hastalarda motor fonksiyon ve duyusal fonksiyon ortalama puanları daha yüksek belirlenmiştir (p<0,05).
Sonuç: Araştırma sonucunda elde edilen bulgular nörotoksik kemoterapi alan kadınlarda ağrı ve yaşam kalitesinin çok yönlü bir sorun olduğunu ve etkili yönetimi için multidisipliner bir yaklaşım gerektirdiğini göstermektedir. Nörotoksik kemoterapi alan hastalara danışmanlık yapan onkoloji hemşirelerinin semptom yönetimi ve değerlendirmelerini tedavinin başında, sürecinde ve sonrasında düzenli olarak yapması önerilir.

Keywords

Periferal nöropati , ağrı , yaşam kalitesi , hemşirelik

Determination of Peripheral Neuropathy Severity and Pain and Quality of Life in Women Receiving Neurotoxic Chemotherapy

Abstract

Objective: This study aimed to assess the levels of peripheral neuropathy severity and pain and quality of life in women undergoing neurotoxic chemotherapy.
Material and Methods: This descriptive study involved 152 female patients who received at least one neurotoxic chemotherapy drugs at the Chemotherapy Unit of Gülhane Training and Research Hospital between February and August 2023, who received at least three cycles of chemotherapy, who had grade 1 and above peripheral neuropathy, were between the ages of 18-65, spoke Turkish, and agreed to participate in the study. Data were collected using the introductory information form, pain and neuropathy evaluation form, quality of life assessment form for cancer patients, and chemotherapy-induced peripheral neuropathy questionnaires.
Results: The study found that chemotherapy-induced peripheral neuropathy significantly impacted quality of life, with 76.65% of participants experiencing pain. Additionally, 77.6% of participants had grade 1 peripheral neuropathy. Women with grade 2 neuropathy had lower physical, role, and emotional function scores compared to those with lower neuropathy severity (p<0.05). They also had higher scores for nausea, pain, and fatigue in the symptom sub-dimensions. Furthermore, grade 2 neuropathy patients had higher motor and sensory function scores on the chemotherapy-induced peripheral neuropathy scale (p<0.05).
Conclusion: The findings obtained as a result of the study show that pain and quality of life in women receiving neurotoxic chemotherapy are multifaceted problems and require a multidisciplinary approach for effective management. Oncology nurses should regularly assess patients for chemotherapy-induced peripheral neuropathy throughout treatment and guide symptom management.

Keywords

Peripheral neuropathy , pain , quality of life , nursing

References

• Türkiye İstatistik Kurumu (TÜİK). Ölüm Nedeni İstatistikleri. 2018. [Atıf 2024 Eylül 15]. Erişim adresi: http://www.tuik.gov.tr/PreTablo.do?alt_id=1083
• American Cancer Society. Cancer prevention & early detection facts & figures 2019-2020. American Cancer Society; 2019 [cited 2024 Sep 15]. Available from: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-prevention-and-early-detection-facts-and-figures/cancer-prevention-and-early-detection-facts-and-figures-2019-2020.pdf
• World Health Organization. WHO report on cancer: setting priorities, investing wisely and providing care for all. 2020 [cited 2024 Sep 15]. Available from: https://www.who.int/publications/i/item/who-report-on-cancer-setting-prioritiesinvesting-wisely-and-providing-care-for-all
• Derksen TM, Bours LJ, Mols F, Weijnberg PM. Lifestyle related factors in the self-management of chemotherapy induced peripheral neuropathy in colorectal cancer: A systematic review. Evid Based Complement Alternat Med. 2017;2017:1-9.
• Zhi WI, Chen P, Kwon A, Chen C, Harte SE, Piulson L, et al. Chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer survivors: A comparison of patient-reported outcomes and quantitative sensory testing. Breast Cancer Res Treat. 2019;178(3):587-95.
• Molinares D, Kurtevski S, Zhu Y. Chemotherapy-induced peripheral neuropathy: Diagnosis, agents, general clinical presentation, and treatments. Curr Oncol Rep. 2023;25(12):1227-35.
• Hsu HT, Wu LM, Lin PC, Juan CH, Huang YY, Chou PL, et al. Emotional distress and quality of life during folinic acid, fluorouracil, and oxaliplatin in colorectal cancer patients with and without chemotherapy-induced peripheral neuropathy: A cross-sectional study. Medicine (Baltimore). 2020;99(6):e19029.
• Sacid G, Arikan F. The evaluation of peripheral neuropathy, daily life activities and quality of life in cancer patients. Acta Oncologica Turcica. 2020;53(3):429-40.
• Seguin C, Kovacevich N, Voutsadakis IA. Docetaxel-associated myalgia-arthralgia syndrome in patients with breast cancer. Breast Cancer - Targets and Therapy. 2017;9:39-44.
• Stoller S, Capozza S, Alberti P, Lustberg M, Kleckner IR. Framework to leverage physical therapists for the assessment and treatment of chemotherapy-induced peripheral neurotoxicity (CIPN). Support Care Cancer. 2023;31(1):293.
• Wang LZ, Li JF, Wang TF, Xie YT, Fan ZQ, He YJ, et al. Long-term recurrence rate and survival in different aged patients with breast cancer undergoing breast conserving therapy. Zhonghua Wai Ke Za Zhi. 2021;59(2):127-33.
• Nardin S, Mora E, Varughese FM, D'Avanzo F, Vachanaram AR, Rossi V, et al. Breast cancer survivorship, quality of life, and late toxicities. Front Oncol. 2020;10:864.
• Biparva AJ, Raoofi S, Rafiei S, Kan FP, Kazerooni M, Bagheribayati F, et al. Global quality of life in breast cancer: systematic review and meta-analysis. BMJ Support Palliat Care. 2023;13(e3):e528-e536.
• Colvin LA. Chemotherapy-induced peripheral neuropathy: where are we now? Pain. 2019;160(S1):S1-S10.
• National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) v5.0. 2017 [cited 2024 Sep 15]. Available from: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcae_v5_quick_reference_5x7.pdf
• Cankurtaran ES, Ozalp E, Soygur H, Ozer S, Akbiyik DI, Bottomley A. Understanding the reliability and validity of the EORTC QLQ-C30 in Turkish cancer patients. Eur J Cancer Care. 2008;17(1):98-104.
• Önsüz Ü, Can G. Taksan Bazlı Tedavi ile İlişkili Periferal Nöropatinin Yönetiminde Girişim Uygulayan ve Uygulamayan Hastaların Yaşam Kalitesi. İzmir Demokrasi Üniversitesi Sağlık Bilimleri Dergisi. 2018;3(2):114-34.
• Dorsey SG, Kleckner IR, Barton D, Mustian K, O’Mara A, St. Germain D, et al. The national cancer institute clinical trials planning meeting for prevention and treatment of chemotherapy-induced peripheral neuropathy. JNCI: Journal of the National Cancer Institute. 2019;111(6):531-7.
• Uçman-Saykal T, Uysal N. The effect of peripheral neuropathy on disability and anxiety. Florence Nightingale Journal of Nursing. 2024;32(1):30-7.
• Bennett MI, Rayment C, Hjermstad M, Aass N, Caraceni A, Kaasa S. Prevalence and aetiology of neuropathic pain in cancer patients: A systematic review. Pain. 2012;153(2):359-65.
• Oh SY, Shin SW, Koh SJ, Bae SB, Chang H, Kim J, et al. Multicenter, cross-sectional observational study of the impact of neuropathic pain on quality of life in cancer patients. Support Care Cancer. 2017;25(12):3759-67.
• Thomas S, Ajroud-Driss S, Dimachkie MM, Gibbons C, Freeman R, Simpson DM, et al. Peripheral neuropathy research registry: A prospective cohort. J Peripher Nerv Syst. 2019;24(1):39-47.
• Miaskowski C, Mastick J, Paul SM, Topp K, Smoot B, Abrams G, et al. Chemotherapy-induced neuropathy in cancer survivors. J Pain Symptom Manag. 2017;54(2):204-18.e2.
• Bonhof CS, van de Poll-Franse LV, Vissers PAJ, Wasowicz DK, Wegdam JA, Révész D, et al. Anxiety and depression mediate the association between chemotherapy-induced peripheral neuropathy and fatigue: Results from the population-based PROFILES registry. Psychooncology. 2019;28(9):1926-33.
• Li T, Park SB, Battaglini E, King MT, Kiernan MC, Goldstein D, et al. Assessing chemotherapy-induced peripheral neuropathy with patient reported outcome measures: A systematic review of measurement properties and considerations for future use. Qual Life Res. 2022;31(12):3091-107.
• Tuğral A, Akyol M. View of perceived symptoms associated with chemotherapy-induced peripheral neuropathy in patients with breast cancer: A cross-sectional study. Forbes Journal of Medicine. 2024;5(2):23-30.
• Yeo F, Ng CC, Loh KWJ, Molassiotis A, Cheng HL, Au JS, et al. Minimal clinically important difference of the EORTC QLQ-CIPN20 for worsening peripheral neuropathy in patients receiving neurotoxic chemotherapy. Support Care Cancer. 2019;27(11):4753-62.
• Winters-Stone KM, Horak F, Jacobs PG, Trubowitz P, Dieckmann NF, Stoyles S, et al. Falls, functioning, and disability among women with persistent symptoms of chemotherapy-induced peripheral neuropathy. J Clin Oncol. 2017;35(23):260.