Şenay AYDIN, Cengiz ÖZDEMİR, Suna TURAN, Yusuf BEŞER, Murat KIYIK

Akciğer kanserinin tedavisinde periferik nöropati; Önemli bir komorbidite

Amaç: Klinik pratigǍimizde akcigǍer kanseri tedavisinde uygulanan kemoterapi rejimlerine bagǍlı gelişen periferik noǅropatiler sık goǅzlenmektedir. Bu çalışmada kemoterapi tedavisi alan ve periferik noǅropati gelişen akcigǍer kanseri tanılı hastalarda klinik semptomlar ve elektrofizyolojik bulguların degǍerlendirilmesi amaçlandı. Yoǅntemler: Ocak 2012- Ocak 2018 tarihleri arasında noǅroloji birimine konsuǅlte edilen ve periferik noǅropati oǅn tanısıyla elektromiyografi (EMG) incelemeleri yapılan akciğer kanseri tanılı hastaların demografik verileri, semptomları, noǅrolojik muayeneleri, EMG bulguları ve tedavilerinde kullanılan kemoterapi ajanları retrospektif olarak goǅzden geçirildi. Noǅropatiye neden olabilecek diyabet esmellitus, uǅremi, tiroid hastalıkları ve digǍer sistemik hastalıklara sahip olan hastalar çalışma dışında bırakıldı. Bulgular: 371 (315, Erkek) hasta çalışmaya dahil edildi. Hastaların 203’ünde (%54,7) pozitif duyusal, 247’inde (%66,6) negatif duyusal, 81‘inde (%21,8) motor semptomlar ve 127 ’inde (%34,2) ağrı semptomları mevcuttu. EMG ile saptanan polinöropati varlığına göre hastalar polinöropati olanlar Grup I (n:250, %67,4) ve olmayanlar Grup II (n:121, %32,6) olarak sınıflandırıldı. Grup I’ de, 160 hastada (%43,1) duyusal, 5 hastada (%1,3) motor, 85 hastada (%22,9) duyusal ve motor liflerin birlikte etkilendiği polinöropati varlığı saptandı. Grup I’ de negatif duyusal semptomlar ile motor semptomlar, Grup II ‘de dizestezi ve parestezi semptomları istatistiksel anlamlılıkta yüksek oranda gözlendi (p=0.001, p=0.001, p=0.001, p=0.001). Sonuç: Akciğer kanseri tedavisinde uygulanan kemoterapi rejimlerine bağlı gelişen periferiknöropatilerde en sık duyusal semptomlar goǅzlenmekte ve kemoterapi ajanına goǅre motor semptomlarda artış goǅzlenebilmektedir.

Peripheral neuropathy in the treatment of lung cancer; an important comorbidity

Objective: In our clinic practice, peripheral neuropathies due to chemotherapy regimens in the treatment of lung cancer are frequently observed. The aim of this study was to evaluate the clinical symptoms and electrophysiological findings of chemotherapy administered patients with lung cancer who developed peripheral neuropathy. Method: The demographic data, symptoms, neurological examinations, EMG findings and chemotherapy agents of the lung cancer patients who were consulted to the neurology department between January 2012 and January 2018 and underwent electromyography (EMG) examinations with the preliminary diagnosis of peripheral neuropathy were reviewed retrospectively. Patients with diabetes mellitus, uremia, thyroid diseases and other systemic diseases that may cause neuropathy were excluded from the study. Results: Three hundred seventy-one (315, male) patients were included in the study. Of these patients, 203 (54.7%) had positive sensory, 247 (66.6%) negative sensory, 81 (21.8%) motor symptoms and 127 (34.2%) had pain symptoms. According to the presence of polyneuropathy detected by electromyography, patients with polyneuropathy were classified as Group I (n: 205, 67.4%) and those without polyneuropathy as Group II (n: 121, 32.6%). In Grup I, we detected sensory polyneuropathy in 160 patients (43.1%), motor polyneuropathy in 5 patients (1.3%) and sensory - motor polyneuropathy in 85 patients (22.9%). It was observed that presence of motor symptoms and negative sensory symptoms in Group I and presence of dysesthesia and paresthesia symptoms in Group II were statistically significant higher II (p=0.001, p=0.001, p=0.001, p=0.001). Conclusion: Sensory symptoms are the most common symptoms in chemotherapy induced polyneuropathy for lung cancer, and an increase in motor symptoms can be observed depending on the chemotherapy agent.

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