Pengaruh kadar albumin terhadap tingkat keparahan taxanes induced peripheral neuropathy pada kanker payudara

https://doi.org/10.22146/bns.v18i3.55026

Nur Cahyani Setiawati(1*), Yudiyanta Yudiyanta(2), Samekto Wibowo(3)

(1) KSM Saraf RSUD dr. Soehadi Prijonegoro, Sragen
(2) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(3) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author

Abstract


Toksisitas jangka panjang pengobatan kanker yang terpenting adalah chemotherapy induced peripheral neuropathy (CIPN), 40% menyebabkan gejala dan kecacatan permanen. Pasien kanker dengan kemoterapi taxanes 80% mengalami taxanes induced peripheral neuropathy (TIPN). Kadar albumin rendah, terbukti berhubungan dengan pengembangan toksisitas kemoterapi. Kadar serum albumin merupakan pemeriksaan rutin sebelum kemoterapi, diharapkan dapat sebagai prediktor CIPN.

Penelitian ini bertujuan mengetahui pengaruh kadar albumin terhadap tingkat keparahan CIPN pada kanker payudara yang mendapat kemoterapi taxanes RSUP Dr. Sardjito Yogyakarta. Rancangan penelitian observasional kohort retrospektif, dengan subjek kanker payudara yang telah selesai 6 siklus kemoterapi taxanes di Poli Kanker Terpadu Tulip. Tingkat keparahan CIPN dinilai menggunakan skor neuropati NCI-CTC versi 3.0. Kadar albumin diperiksa di Instalasi Patologi Klinik sebelum menjalani kemoterapi. Seluruh data kemudian diolah untuk analisis statistik secara komputerisasi.

Sebanyak 50 subjek mengikuti penelitian dengan rerata usia 51,52±10,05 tahun dan kadar albumin 4,07±0,47 g/dL. Hasil analisis bivariat didapatkan 2 faktor bermakna secara signifikan mempengaruhi tingkat keparahan CIPN baik sensorik maupun motorik yaitu kadar albumin (neuropati sensorik p =0,002, motorik p =0,002) dan usia (neuropati sensorik p =0,039 dan motorik p =0,001). Setelah dilakukan analisis multivariat menunjukkan bahwa hanya kadar albumin (neuropati sensorik p =0,009 dan motorik p =0,010) yang merupakan faktor independen yang mempengaruhi tingkat keparahan CIPN

Berdasarkan penelitian ini, terdapat pengaruh kadar albumin terhadap tingkat keparahan CIPN, yaitu kadar albumin yang lebih rendah memiliki tingkat CIPN yang lebih parah.


Keywords


albumin; CIPN; kanker payudara; taxanes

Full Text:

PDF


References

1. Park SB, Goldstein D, Krishnan A V, Lin CS, Friedlander L, Cassidy J, et al. Chemotherapy-Induced Peripheral Neurotoxicity : A Critical Analysis. 2013;63(6):419–437.

2. Mark J. Lema, Kathleen M. Foley Fr, Hausheer H. Assessment of Cancer-Related Neuropathy and Neuropathic Pain. The Oncologist. 2010;15(suppl 2):3–8.

3. Iuliis F De, Taglieri L, Salerno G, Lanza R, Scarpa S. Taxane Induced Neuropathy in Patients Affected by Breast Cancer : Literature Review. Crit Rev Oncol/Hematol [Internet]. Elsevier Ireland Ltd; 2015;1–12. Available from: http://dx.doi.org/10.1016/j.critrevonc.2015.04.011

4. Seretny M, Currie GL, Sena ES, Ramnarine S, Grant R, Macleod MR, et al. Incidence, Prevalence, and Predictors of Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis. Pain [Internet]. International Association for The Study of Pain; 2014;155(12):2461–2470. Available from: http://dx.doi.org/10.1016/j.pain.2014.09.020

5. Buyukcelik A. Albumin Infusion is Not Beneficial in Hypoalbuminemic End-Stage Cancer Patients: A Matched-Pair Analysis. Int J Hematol Oncol [Internet]. 2012;22(4):213–219. Available from: http://www.uhod.org/pdf/PDF_533.pdf

6. Arrieta O, Ortega RMM, Villanueva-rodríguez G, Serna-thomé MG, Flores-estrada D, Diaz-romero C, et al. Association of Nutritional Status and Serum Albumin Levels with Development of Toxicity in Patients with Advanced Non-Small Cell Lung Cancer Treated with Paclitaxel-Cisplatin Chemotherapy : A Prospective Study. BMC Cancer. 2010;(22):1–7.

7. Gupta D, Lis CG. Pretreatment Serum Albumin as A Predictor of Cancer Survival: A Systematic Review of The Epidemiological Literature. Nutr J [Internet]. BioMed Central Ltd; 2010;9(1):69. Available from: http://www.nutritionj.com/content/9/1/69

8. Park JH, Mcmillan DC, Horgan PG, Roxburgh CS. The Impact of Anti-Inflammatory Agents on The Outcome of Patients with Colorectal Cancer. Cancer Treat Rev [Internet]. Elsevier Ltd; 2014;40(1):68–77. Available from: http://dx.doi.org/10.1016/j.ctrv.2013.05.006

9. Cavaletti G, Cornblath DR, Merkies ISJ, Postma TJ, Rossi E, Frigeni B, et al. The Chemotherapy-Induced Peripheral Neuropathy Outcome Measures Standardization Study: from Consensus to The First Validity and Reliability Findings. Ann Oncol [Internet]. 2013;24(2):454–462. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3551481 &tool=pmcentrez&rendertype=abstract

10. Vincenzi B, Frezza AM, Schiavon G, Spoto C, Silvestris N, Addeo R, et al. Identification of Clinical Predictive Factors of Oxaliplatin-Induced Chronic Peripheral Neuropathy in Colorectal Cancer Patients Treated with Adjuvant Folfox IV. Support Care Cancer [Internet]. 2013;21(5):1313–1319. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23196819

11. Li L, Liu B, Lu J, Jiang L, Zhang Y, Shen Y. Serum Albumin is Associated With Peripheral Nerve Function in Patients With Type 2 Diabetes. 2015;397–404.

12. Bussink M. The Role of Nutrition on Effectiveness of Chemotherapy (Thesis). 2012;1–30. Available from: http://dspace.library.uu.nl/handle/1874/236433

13. Nassini R, Benemei S, Fusi C, Trevisan G, Materazzi S. Transient Receptor Neuropathy Potential Channels in Chemotherapy-Induced Neuropathy. The Open Pain Journal. 2013;127–136.

14. Tabernero A, Granda B, Medina A, Sánchez-Abarca LI, Lavado E, Medina JM. Albumin Promotes Neuronal Survival by Increasing The Synthesis and Release Of Glutamate. J Neurochem. 2002;81(4):881–891.

15. Laird BJ, C.Mcmillan D, Fayer P, Fearon K, Kaasa S, Fallon MT, et al. The Systemic Inflammatory Response and Its Relationship to Pain and Other Symptoms in Advanced Cancer. The Oncologist. 2013;1050–1055.

16. Reyes-gibby CC, Morrow PK, Buzdar A, Shete S. Chemotherapy-Induced Peripheral Neuropathy as a Predictor of Neuropathic Pain in Breast Cancer Patients Previously Treated With Paclitaxel. J Pain [Internet]. Elsevier Ltd; 2009;10(11):1146–1150. Available from: http://dx.doi.org/10.1016/j.jpain.2009.04.006

17. Tanabe Y, Hashimoto K, Shimizu C, Hirakawa A, Harano K, Yunokawa M. Paclitaxel-Induced Peripheral Neuropathy in Patients Receiving Adjuvant Chemotherapy For Breast Cancer. Int J Clin Oncol. 2013;132–138.

18. Muss HB, Berry DA, Cirrincione C, Budman DR, Henderson IC, Citron ML, et al. Toxicity of Older and Younger Patients Treated With Adjuvant Chemotherapy for Node-Positive Breast Cancer : The Cancer and Leukemia Group B Experience. Journal Of Clinical Oncology. 2016;25(24):3699–3704.

19. Montoya JE, Luna HG, Morelos AB, Catedral MM, Lava AL, Amparo JR. Association of Creatinine Clearance with Neutropenia in Breast Cancer Patients Undergoing Chemotherapy with Fluorouracil, Doxorubicin, and Cyclophosphamide ( FAC ). Med J Malaysia. 2013;68(2):153–156.

20. Chua W, Kho PS, Moore MM, Charles KA, Clarke SJ. Clinical , laboratory and molecular factors predicting chemotherapy efficacy and toxicity in colorectal cancer. Crit Rev Oncol / Hematol [Internet]. Elsevier Ireland Ltd; 2011;79(3):224–250. Available from: http://dx.doi.org/10.1016/j.critrevonc.2010.07.012

21. Hurria A, Togawa K, Mohile SG, Owusu C, Klepin HD, Gross CP, et al. Predicting Chemotherapy Toxicity in Older Adults With Cancer : A Prospective Multicenter Study. Journal Of Clinical Oncology. 2011;29(25):3457–3465.

22. Degirmency, Kececi. Electrophysiologıcal Changes in Iron Deficiency Anemia. Neurol Croas. 2011;60(1):5

23. Kabakus N, Ayar A, Yoldas K, Ulvi H, Dogan Y, Yilmaz B, et al. Reversal of Iron Deficiency Anemia-induced Peripheral Neuropathy by Iron Treatment in Children with Iron Deficiency Anemia. Journal of Tropical Pediatric. 2002;48(8):204-209

24. Guastalla J, Dieras V. The Taxanes: Toxicity and Quality of Life Considerations in Advanced Ovarian Cancer. British Journal of Cancer. 2003;89:16–22.

25. Argyriou AA, Kyritsis AP, Makatsoris T, Kalofonos HP. Chemotherapy-Induced Peripheral Neuropathy in Adults: A Comprehensive Update of The Literature. Cancer Management and Research. 2014;135–47.



DOI: https://doi.org/10.22146/bns.v18i3.55026

Article Metrics

Abstract views : 1351 | views : 2609

Refbacks

  • There are currently no refbacks.


Copyright (c) 2020 Berkala NeuroSains

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.