Hubungan rasio neutrofil limfosit dengan keparahan taxane induced peripheral neuropathy pada pasien kanker payudara

Abstract

Taxane induced peripheral neuropathy is very common in patients with breast cancer and can reach up to 80% of all patients receiving taxane therapy. The ratio of lymphocyte neutrophils (NLR) is a routine procedure performed to prove a systemic inflammatory response. This study aims to determine the correlation between the ratio of neutrophil lymphocytes to the severity of CIPN in breast cancer patients who received taxane chemotherapy. Retrospective cohort studies were performed by measuring the severity variable of neuropathy using National Cancer Institute-Common Toxicity Criteria (NCI- CTC) version III neuropathy scale performed at the time of study, then for the neutrophil lymphocyte ratio derived from the patient’s medical records prior to the first chemotherapy. Of the 72 candidate subjects, there were 69 subjects who could follow the study. The results of bivariate analysis of the ratio of neutrophil lymphocytes (NLR) to the severity of chemotherapy induced peripheral neuropathy (CIPN) found a significant correlation with sensory neuropathy (p =0.045, r =0.242) and motor neuropathy (p =0.022, r =0.275). In the analysis with ordinal logistic regression the NLR variable did not affect the severity of CIPN independently with p =0.748 and p =0.422 in sensory and motor neuropathy. The results of this study obtained a significant correlation between the ratio of neutrophil lymphocytes (NLR) to the severity of both sensory and motoric chemotherapy induced peripheral neuropathy (CIPN) in breast cancer patients receiving taxane chemotherapy, but with a relatively low correlation coefficient. In a multivariate analysis, NLR did not independently have a correlation with CIPN severity.

ABSTRAK

Taxane induced peripheral neuropathy sangat sering ditemui pada pasien dengan kanker payudara dan dapat mencapai 80% dari keseluruhan pasien yang mendapat terapi taxane. Rasio neutrofil limfosit (RNL) adalah suatu prosedur yang rutin dilakukan untuk membuktikan suatu respons inflamasi sistemik. Untuk mengetahui hubungan rasio neutrofil limfosit terhadap tingkat keparahan CIPN pada pasien kanker payudara yang mendapat kemoterapi taxane, dilakukan penelitian kohort retrospektif dengan melakukan pengukuran tingkat keparahan neuropati menggunakan skala neuropati National Cancer Institute-Common Toxicity Criteria (NCI-CTC) versi 3 yang dicatat pada saat studi, sedangkan rasio neutrofil limfosit diambil dari catatan medis pasien sebelum dilakukan kemoterapi yang pertama. Dari 72 calon subjek, ada 69 subjek yang dapat mengikuti penelitian. Hasil analisis bivariat rasio neutrofil limfosit (RNL) terhadap tingkat keparahan chemotherapy induced peripheral neuropathy (CIPN) mendapatkan korelasi yang bermakna terhadap neuropati sensorik (p =0,045, r =0,242) dan neuropati motorik (p

=0,022, r =0,275). Pada analisis dengan regresi logistik ordinal menunjukkan variabel RNL tidak mempengaruhi tingkat keparahan CIPN secara independen dengan p =0,748 dan p =0,422 pada neuropati sensorik dan motorik. Hasil dari penelitian ini mendapatkan korelasi yang bermakna antara rasio neutrofil limfosit (RNL) terhadap keparahan chemotherapy induced peripheral neuropathy (CIPN) baik sensorik dan motorik pada pasien kanker payudara yang mendapat kemoterapi taxane, namun dengan koefisien korelasi yang tidak terlalu tinggi. Pada analisis multivariat, RNL tidak secara independen memiliki hubungan dengan tingkat keparahan CIPN.