葉篤學 ;吳天元Ndabenhle Cedric Dlamini2026-05-062026-05-062025-07-15https://203.71.86.71/handle/123456789/9246學位別：碩士 口試委員：吳天元; 邵于宣; 陳香吟; 楊軒佳; 葉篤學 關鍵字：Cancer、Tyrosine Kinase Inhibitors、TKI-induced Neuropathy、Taipei Medical University Clinical Research DatabaseBackground Neuropathy is a significant adverse event in oncology patients undergoing treatment with tyrosine kinase inhibitors (TKIs), yet its risk factors remain context-dependent. This study aimed to identify factors associated with neuropathy in a TKI-treated cancer cohort and examine correlations with other TKI-related adverse events. Objective To quantify the incidence of neuropathy among TKI-treated cancer patients, identify associated risk factors, compare rates across TKI types, and evaluate the relationship between neuropathy and other TKI-related adverse events. Methods This retrospective cohort study utilized data from the Taipei Medical University Clinical Research Database (TMUCRD), including its embedded cancer registry, to examine inpatient and outpatient cancer patients treated with TKIs from January 2016 to June 2019. To exclude pre-exposure to TKI therapy, a 12-month washout period was applied before the index date. Eligible patients were ≥20 years, diagnosed with cancer from the registry, initiating first-time TKI therapy, had documented use of neuropathy relief medication, and had complete comorbidity records. Patients with pre-existing neuropathy or those who discontinued TKI within one month for unrelated reasons were excluded. Data included demographics, comorbidities, cancer type/stage, and adverse events identified via ICD codes. Results Of 704 patients, 159 (22.6%) developed TKI-induced neuropathy. A weighted stepwise logistic regression identified younger age (OR = 0.987, p = 0.009), diabetes mellitus (OR = 1.80, p = 0.002), stomatitis (OR = 2.96, p = 0.025), cough (OR = 2.60, p = 0.006), constipation (OR = 1.59, p = 0.022), and docetaxel use (OR = 2.91, p = 0.008) as significant risk factors. The model showed modest discrimination (AUC = 0.600) and acceptable calibration (Hosmer–Lemeshow p = 0.070). No individual adverse event was strongly correlated with neuropathy (all ρ > 0.05). Conclusion Younger age, diabetes, and symptoms such as stomatitis, cough, and constipation, as well as docetaxel use, may be risk factors of TKI-induced neuropathy. These findings support improved risk identification and targeted monitoring strategies in real-world oncology practice.系所名稱：藥學系碩士班thesis