TAKSAN BAZLI TEDAVİ İLE İLİŞKİLİ PERİFERAL NÖROPATİNİN YÖNETİMİNDE GİRİŞİM UYGULAYAN VE UYGULAMAYAN HASTALARIN YAŞAM KALİTESİ

Öz

Periferik sinir liflerinin zedelenmesi ve dejenerasyonu sonucunda gelişen kemoterapi ilişkili periferal nöropati, özellikle taksan bazlı tedavi alan
hastaların yaşam kalitesini olumsuz etkileyen önemli bir toksisitedir. Bu çalışma, taksan bazlı tedavi nedeniyle periferal nöropati gelişen
hastaların kullandığı başetme yaklaşımlarını belirlemek ve başetme girişimi kullanmının hastaların yaşam kalitesine etkisi olup olmadığını
belirlemek amacıyla planlanmıştır. Tanımlayıcı nitelikte olan bu çalışma; bir üniversite hastanesinin kemoterapi ünitesinde taksan bazlı tedavi
alan ve evre ≥1 periferal nöropatisi olan 100 kanser hastasının katılımı ile gerçekleştirilmiştir. Hastalara ait veriler, Hasta Tanılama Formu, Yan
Etkiler İçin Ortak Terminoloji Kriterleri, Performans Skalası, Yaşam Kalitesi ve Kemoterapi ile İndüklenen Periferal Nöropati ölçekleri
kullanılarak toplanmıştır. Hastaların %50’sinin performans skorunu ≥2, %79’unun evre ≥2 periferal nöropatisi olduğu, %60’ının semptom
yönetiminde girişim uyguladığı saptanmıştır. Periferal nöropati ile başetme girişimi uygulayan ve uygulamayan hastaların yaşam kalitesi puanları
arasında istatistiksel olarak anlamlı fark saptanmamıştır. Bu çalışmada KİPN’li kanser hastalarının nöropatik semptomları yönetmek için kendi
kendine farklı yaklaşımlar kullandıkları saptanmıştır. Bu yönetim stratejilerinin etkinliğine ilişkin karar verebilmek için seçilen tamamlayıcı
yaklaşım ile ilgili önemli olan değişkenler incelenerek daha büyük hasta grupları üzerinde yüksek kaliteli kanıtları olan çalışmalar yapılmalıdır

Anahtar Kelimeler

• Kanser
• Periferal Nöropati
• Taksan
• Semptom Yönetimi
• Yaşam Kalitesi

THE QUALITY OF LIFE OF CANCER PATIENTS WHO HAVE AND NOT APPLY INTERVENTION IN THE MANAGEMENT OF TAXANE INDUCED PERIPHERAL NEUROPATHY

Öz

Chemotherapy-related peripheral neuropathy, which develops as a result of injury and degeneration of peripheral nerve fibers, is an important
toxicity that adversely affects the quality of life of patients receiving taxane-based therapy. This study was planned to determine the coping
approaches used by patients who developed peripheral neuropathy due to taxane-based treatment and to determine whether the use of coping
intervention has an impact on the quality of life of patients. This descriptive study was performed with the participation of 100 cancer patients
with grade≥1 peripheral neuropathy who were treated with taxane-based treatment in a chemotherapy unit of a university hospital. Study data
were obtained in a single interview using the Patient Identification Form, Performance Scale, Common Terminology Criteria for Adverse Events,
Quality of Life Questionnaire and Chemotherapy-Induced Peripheral Neuropathy scales. It was found that 50% of the patients performance score
were ≥2, 79% had grade ≥2 peripheral neuropathy, 60% of the patients applied intervention in symptom management. There was no statistically
significant difference between the quality of life scores of patients who applied and did not attempt to cope with peripheral neuropathy. In this
study, it was found that cancer patients with CIPN used different approaches to manage neuropathic symptoms. In order to decide on the
effectiveness of these management strategies, important variables related to the complementary approach should be examined and studies with
higher quality evidence should be conducted on larger patient groups.

Anahtar Kelimeler

• cancer
• peripheral neuropathy
• Quality of life
• symptom management
• taxane

Kaynakça

1. Bakogeorgos, M., & Georgoulias, V. (2017). Risk-reduction and treatment of chemotherapy-induced peripheral neuropathy. Expert review of anticancer therapy, 17(11), 1045-1060. doi: 10.1080/14737140.2017.
2. Beşer, N., ve Öz, F. (2003). Kemoterapi Alan Lenfomalı Hastaların Anksiyete-Depresyon Düzeyleri Ve Yaşam Kalitesi. Cumhuriyet Üniversitesi Hemşirelik Yüksek Okulu Dergisi, 7, 47-58. Erişim tarihi 15.01.2015, http://eskidergi.cumhuriyet.edu.tr/makale/623.pdf.
3. Bland, K. A., Kirkham, A. A., Bovard, J., Shenkier, T., Zucker, D., McKenzie, D. C., ... & Campbell, K. L. (2019). Effect of exercise on taxane chemotherapy-induced peripheral neuropathy in women with breast cancer: a randomized control trial. Clinical Breast Cancer. doi: 10.1007/s00432-018-2686-5.
4. Brami, C., Bao, T., & Deng, G. (2016). Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: a systematic review. Critical reviews in oncology/hematology, 98, 325-334. doi: 10.1016/j.critrevonc.2015.11.014.
5. Can, G., Erol, O., Aydiner, A., & Topuz, E. (2011). Non-pharmacological interventions used by cancer patients during chemotherapy in Turkey. European Journal of Oncology Nursing, 15(2), 178-184. doi: 10.1016/j.ejon.2010.07.005.
6. Cioroiu, C., & Weimer, L. H. (2017). Update on chemotherapy-induced peripheral neuropathy. Current neurology and neuroscience reports, 17(6), 47. doi: 10.1007/s11910-017-0757-7.
7. Dixit, S., Maiya, A., & Shastry, B. (2014). Effect of aerobic exercise on quality of life in population with diabetic peripheral neuropathy in type 2 diabetes: a single blind, randomized controlled trial. Quality of Life Research, 23(5), 1629-1640. doi: 10.1007/s11136-013-0602-7.
8. Dorsey, S. G., Kleckner, I. R., Barton, D., Mustian, K., O’Mara, A., St Germain, D., ... & Hoke, A. (2019). The National Cancer Institute Clinical Trials Planning Meeting for Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy. JNCI: Journal of the National Cancer Institute. doi: 10.1093/jnci/djz011.

9. Duregon, F., Vendramin, B., Bullo, V., Gobbo, S., Cugusi, L., Di Blasio, A., ... & Ermolao, A. (2018). Effects of exercise on cancer patients suffering chemotherapy-induced peripheral neuropathy undergoing treatment: a systematic review. Critical reviews in oncology/hematology, 121, 90-100. doi: 10.1016/j.critrevonc.2017.11.002.
10. Ertem, G., Kalkım, A., Bulut, S., ve Sevil, Ü. (2009). Radyoterapi alan hastaların evde bakım gereksinimleri ve yaşam kaliteleri. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi, 2(2), 3-12. Erişim tarihi 15.01.2015, http://hemsirelik.maltepe.edu.tr/dergiler/cilt2sayi2/3_12.pdf.
11. Fayers, P., Aaronson, N. K., Bjordal, K., Groenvold, M., Curran, D., & Bottomley, A. (2015). The EORTC QLQ-C30 Scoring Manual. 2001. Brussels: European Organisation for Research and Treatment of Cancer, 3.
12. Galantino, M. L., Tiger, R., Brooks, J., Jang, S., & Wilson, K. (2019). Impact of somatic yoga and meditation on fall risk, function, and quality of life for chemotherapy-induced peripheral neuropathy syndrome in cancer survivors. Integrative cancer therapies, 18, doi: 10.1177/1534735419850627.
13. Ghavami, H., Aldin Shamsi, S., Soheili, S., Radfar, M., & Khalkhali, H. R. (2018). Effect of lifestyle interventions on diabetic peripheral neuropathy in patients with type 2 diabetes, result of a randomized clinical trial. Agri, 30(4), 165-170. doi: 10.5505/agri.2018.45477.
14. Izgu, N., Metin, Z. G., Karadas, C., Ozdemir, L., Çetin, N., & Demirci, U. (2019). Prevention of chemotherapy-induced peripheral neuropathy with classical massage in breast cancer patients receiving paclitaxel: An assessor-blinded randomized controlled trial. European Journal of Oncology Nursing. doi:10.1016/j.ejon.2019.03.002
15. Izgu, N., Ozdemir, L., & Basal, FB. (2019). Effect of Aromatherapy Massage on Chemotherapy-Induced Peripheral Neuropathic Pain and Fatigue in Patients Receiving Oxaliplatin: An Open Label Quasi–Randomized Controlled Pilot Study. Cancer nursing, 42(2), 139-147. doi: 10.1016/j.ejon.2019.03.002.
16. Jordan, B., Jahn, F., Sauer, S., & Jordan, K. (2019). Prevention and Management of Chemotherapy-Induced Polyneuropathy. Breast Care, 14(2), 79-84. doi: 10.1159/000499599.
17. Kieffer, J. M., Postma, T. J., van de Poll-Franse, L., Mols, F., Heimans, J. J., Cavaletti, G., ... & CI-PeriNomS Group. (2017). Evaluation of the psychometric properties of the EORTC chemotherapy-induced peripheral neuropathy questionnaire (QLQ-CIPN20). Quality of Life Research, 26(11), 2999-3010. doi: 10.1007/s11136-017-1626-1.
18. Kleckner, I. R., Kamen, C., Gewandter, J. S., Mohile, N. A., Heckler, C. E., Culakova, E., ... & Reddy, P. S. (2018). Effects of exercise during chemotherapy on chemotherapy-induced peripheral neuropathy: a multicenter, randomized controlled trial. Supportive Care in Cancer, 26(4), 1019-1028. doi: 10.1007/s00520-017-4013-0.
19. Kuzeyli YY. (2007). Nörotoksisite. G., Can (Ed.). Onkoloji Hemşireliğinde Semptom Yönetimi. 1.Baskı. İstanbul, 3P-Pharma Publication Planning;159-174. Liu, Y. W., Liu, C. T., Su, Y. L., & Tsai, M. Y. (2019). A Narrative Review of Complementary Nutritional Supplements for Chemotherapy-induced Peripheral Neuropathy. Alternative therapies in health and medicine.
20. Lu, W., Giobbie‐Hurder, A., Freedman, R. A., Lin, N. U., Partridge, A. H., Rosenthal, D. S., & Ligibel, J. A. (2019). Acupuncture for Chemotherapy‐Induced Peripheral Neuropathy in Breast Cancer Survivors: A Randomized Controlled Pilot Trial. The oncologist, theoncologist-2019. doi: 10.1634/theoncologist.2019-0489.
21. McCrary, J. M., Goldstein, D., Sandler, C. X., Barry, B. K., Marthick, M., Timmins, H. C., ... & Park, S. B. (2019). Exercise-based rehabilitation for cancer survivors with chemotherapy-induced peripheral neuropathy. Supportive Care in Cancer, 1-9. doi: 10.1007/s00520-019-04680-w.
22. National Cancer Institute. (2006). Cancer Therapy Evaluation Program; Common Terminology Criteria for Adverse Events, Version 3.0 (CTCAE). (09 Ağustos 2006). Erişim tarihi: 09.08.2008, http://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/ctcaev3.pdf.
23. Pachman, D. R., Watson, J. C., Lustberg, M. B., Wagner-Johnston, N. D., Chan, A., Broadfield, L., ... & Paice, J. (2014). Management options for established chemotherapy-induced peripheral neuropathy. Supportive Care in Cancer, 22(8), 2281-2295. doi: 10.1007/s00520-014-2289-x.
24. Park, R., & Park, C. (2015). Comparison of foot bathing and foot massage in chemotherapy-induced peripheral neuropathy. Cancer nursing, 38(3), 239-247. doi: 10.1097/NCC.0000000000000181.
25. Pignataro, R. M., & Swisher, A. K. (2010). Chemotherapy induced peripheral neuropathy: risk factors, pathophysiology, assessment, and potential physical therapy interventions. Rehabilitation Oncology, 28(2), 10-18. Erişim Tarihi 15.01.2015, https://journals.lww.com/rehabonc/Abstract/2010/28020/Chemotherapy_Induced_Peripheral_Neuropathy__Risk.2.aspx#pdf-link.
26. Postma, T. J., Aaronson, N. K., Heimans, J. J., Muller, M. J., Hildebrand, J. G., Delattre, J. Y., ... & Moynihan, C. (2005). The development of an EORTC quality of life questionnaire to assess chemotherapy-induced peripheral neuropathy: the QLQ-CIPN20. European journal of cancer, 41(8), 1135-1139. doi: 10.1016/j.ejca.2005.02.012
27. Prigerson, H. G., Bao, Y., Shah, M. A., Paulk, M. E., LeBlanc, T. W., Schneider, B. J., ... & Neugut, A. I. (2015). Chemotherapy use, performance status, and quality of life at the end of life. JAMA oncology, 1(6), 778-784. doi: 10.1001/jamaoncol.2015.2378.
28. Schloss, J., & Colosimo, M. (2017). B vitamin complex and chemotherapy-induced peripheral neuropathy. Current oncology reports, 19(12), 76. doi 10.1007/s11912-017-0636-z.
29. Schloss, J. M., Colosimo, M., Airey, C., Masci, P., Linnane, A. W., & Vitetta, L. (2017). A randomised, placebo-controlled trial assessing the efficacy of an oral B group vitamin in preventing the development of chemotherapy-induced peripheral neuropathy (CIPN). Supportive Care in Cancer, 25(1), 195-204. doi: 10.1007/s00520-016-3404-y
30. Seretny, M., Currie, G. L., Sena, E. S., Ramnarine, S., Grant, R., MacLeod, M. R., ... & Fallon, M. (2014). Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis. PAIN®, 155(12), 2461-2470. doi: 10.1016/j.pain.2014.09.020.
31. Önsüz, Ü., (2015). Taksan Bazlı Tedavi Alan Kanser Hastalarında Oluşan Periferal Nöropatinin Yönetiminde Hastalar Tarafından Uygulanan Girişimlerin Etkinliği. (Yayımlanmamış yüksek lisans tezi). İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul.
32. Zajączkowska, R., Kocot-Kępska, M., Leppert, W., Wrzosek, A., Mika, J., & Wordliczek, J. (2019). Mechanisms of Chemotherapy-Induced Peripheral Neuropathy. International journal of molecular sciences, 20(6), 1451-1480. doi: 10.3390/ijms20061451.
33. Zimmer, P., Trebing, S., Timmers-Trebing, U., Schenk, A., Paust, R., Bloch, W., ... & Baumann, F. T. (2018). Eight-week, multimodal exercise counteracts a progress of chemotherapy-induced peripheral neuropathy and improves balance and strength in metastasized colorectal cancer patients: a randomized controlled trial. Supportive Care in Cancer, 26(2), 615-624. doi: 10.1007/s00520-017-3875-5.