Impact of Chemotherapy-Induced Peripheral Neuropathy on Quality of Life in Patients with Advanced Lung Cancer Receiving Platinum-Based Chemotherapy

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of neurotoxic anticancer drugs that may affect quality of life (QoL). Purpose: The purposes of this study were to: assess the levels of CIPN, anxiety, depression, CIPN–related QoL, and general QoL; and identify the factors related to CIPN–related QoL and general QoL in patients with advanced lung cancer (LC) receiving platinum-based chemotherapy. This cross-sectional study examined patients with advanced LC who received platinum-based chemotherapy from the thoracic oncology inpatient wards of a medical center in northern Taiwan. Structured questionnaires were used to measure patients’ CIPN (European Organization for Research and Treatment of Cancer quality of life questionnaire–chemotherapy–induced peripheral neuropathy 20), anxiety (Hospital Anxiety and Depression Scale Depression Scale [HADS]), depression (HADS), CIPN-related QoL (Functional Assessment of Cancer Therapy /Gynecologic Oncology Group-Neurotoxicity subscale [FACT/GOG–Ntx]), and general QoL (Functional Assessment of Cancer Therapy–General Input [FACT-G]). Of 93 patients with advanced LC, 53.8% reported CIPN–sensory impairment and 47.3% reported CIPN–motor impairment. The most common CIPN symptoms were difficulty getting or maintaining an erection (only for men > 65 years) and difficulty in climbing stairs or getting up out of a chair. Poor CIPN–related QoL (FACT/GOG–Ntx) was associated with more CIPN–sensory and more CIPN–motor impairment. Poor general QoL (FACT-G) was associated with a higher level of depression, a higher level of anxiety, and receipt of more chemotherapy cycles. More than half of LC patients report impairment related to CIPN, calling for holistic treatment to improve QoL.

The impact of peripheral neuropathy symptoms, self-care ability, and disturbances to daily life on quality of life among gynecological cancer patients undergoing chemotherapy: a cross-sectional survey

“…This study was conducted to analyze data from gynecological cancer patients undergoing chemotherapy to understand the relationship between peripheral neuropathy symptoms, self-care ability, and disturbances to daily life, and identify the factors that affect QoL. The QoL of gynecological cancer patients in this study was lower than in prior international and domestic studies conducted using the same instrument, which included QoL scores of 64.8 points [11], 78.8 points [28], 67.69 points [29], and 69.32 points [30]. The low QoL in this study was likely due to the high proportion of ovarian cancer patients at 70%; over 60% to 70% of whom had stage 3 or 4 cancer when they were diagnosed, as over 70% may experience recurrence even after treatment [15].…”

Non-Pharmacological Self-Management Strategies for Chemotherapy-Induced Peripheral Neuropathy in People with Advanced Cancer: A Systematic Review and Meta-Analysis

“…Furthermore, people with advanced cancer often have continuous chemotherapy cycles where acute or chronic CIPN is experienced, which presents a unique challenge for this population. Symptoms of CIPN can negatively affect sleep, mood, mobility, activities of daily living, and lead to distress, anxiety, depression, financial toxicity, difficulty feeding, constipation and diarrhea, which further compromise cancer treatment outcomes and quality of life [7][8][9][10][11].…”

Psychosocial adaptation and influencing factors among patients with chemotherapy-induced peripheral neuropathy

“…The taxane, platinum, and vinca alkaloids are the agents most commonly associated with CIPN. It can cause dysfunction of motor, sensory and autonomic neurons, manifesting as signs and symptoms of peripheral neuropathic, including sensory damage[ 1 ]. The mechanisms of peripheral neuropathy induced by oxaliplatin and taxane drugs are ion channels altering the excitability of peripheral neurons, mitochondrial damage leading to peripheral nerve apoptosis, and inflammation leading to nociceptor sensitization and the development of neuroinflammation[ 2 , 3 ].…”

“…After the treatment, there is an improvement over time, but some patients continue to have symptoms for many years[ 4 ]. Among patients with advanced lung cancer treated with oxaliplatin regimens, 53.8% reported sensorineural impairment, and 47.3% reported motor neuron impairment[ 1 ]. Selvy et al [ 9 ] showed that 36.5% of patients still had CIPN 5 years after the end of oxaliplatin chemotherapy.…”