Long‐term symptoms of polyneuropathy in breast and colorectal cancer patients treated with and without adjuvant chemotherapy

Abstract

Background The aim of this study was to assess chemotherapy‐induced polyneuropathy (CIPN) 5 years after adjuvant chemotherapy in patients with breast and colorectal cancer. The association of CIPN with quality of life, anxiety, and depression was analyzed. Methods Of a set of 100 patients with breast cancer and of 74 with colorectal cancer who had undergone surgery and adjuvant chemotherapy in 2011‐2012, 80 and 52 patients alive, respectively, were included together with two reference groups of 249 breast cancer patients and 83 colorectal cancer patients who had undergone surgery only. All patients were sent a questionnaire on alcohol consumption, smoking habits, comorbidity, medicine consumption, and oxaliplatin‐specific questions, as well as the Michigan Neuropathy Screening Instrument questionnaire (MNSIq), the Douleur Neuropathique 4 Questions (DN4q), the EQ‐5D, and the Hospital Anxiety and Depression Scale. Possible polyneuropathy was defined as the presence of numbness and/or tingling in the feet, secondly as a score of ≥4 on the MNSIq. Possible painful polyneuropathy was defined as pain in both feet and a score ≥3 on the DN4q. Results The prevalence of possible polyneuropathy defined by numbness and/or tingling in the feet was 38.8% (28.1‐50.3) after adjuvant docetaxel and 57.7% (43.2‐71.3) after adjuvant oxaliplatin, with no significant difference from a previous 1‐year follow‐up ( P >.35). Fewer had possible polyneuropathy as defined by the MNSIq. Patients with possible polyneuropathy after adjuvant chemotherapy reported significantly lower quality of life than patients treated with surgery only. Conclusion Symptoms of polyneuropathy following adjuvant docetaxel and oxaliplatin persist 5 years after treatment and affect quality of life negatively.

Oxaliplatin‐ and docetaxel‐induced polyneuropathy: clinical and neurophysiological characteristics

“…Coasting has been shown to worsen the sensory neuropathic symptoms of oxaliplatin after ended treatment, 46 this phenomenon is not described in docetaxel treated patients, but the few studies looking at the development of symptoms of polyneuropathy after docetaxel have shown that the symptoms persist in 32% to 42% of the patients. 28,47,48 Of the 41 patients with probable or confirmed CIPN, 30% had neuropathic pain in the feet (painful CIPN). In general, the pain .58…”

“…However, despite a difference in symptoms in the acute phase, the symptoms and signs of chronic neuropathy are similar between docetaxel and oxaliplatin, supporting the decision to merge the data from patients, who had received docetaxel and oxaliplatin. 28,42 Using a multimodal testing in a representative group of consecutive patients treated with docetaxel and oxaliplatin, we provide a detailed characterization of long-term CIPN. Confirmed CIPN was present in 41%, of these 42% had neuropathic pain.…”

“…27 At the 5-year follow-up, 80 of 94 eligible patients (85%) treated with docetaxel and 52 of 57 eligible patients (91%) treated with oxaliplatin answered a questionnaire about symptoms of neuropathy, these results are published elsewhere. 28 These patients were invited to participate in this study, which was carried out from 2016 to 2017. The control study participants used in this study were local age-matched individuals recruited from other outgoing studies at the center.…”

“…Demographics are presented in Table 1. There were no statistical significant differences in clinical characteristics and the percentage reporting symptoms of neuropathy in the questionnaire study, 28 between those who participated in the clinical study and those who did not, except for the number of patients with diabetes in patients treated with docetaxel (3/28 participating and 0/52 not participating) (Table S2). (Table S3).…”

Lipid-Based Drug Delivery Nanoplatforms for Colorectal Cancer Therapy

“…Although the survival rate of early-stage CRC patients is relatively high (above 50%, stages 0 to II-B), those diagnosed in advanced stages (for example stages IIIB–IVB) exhibit an extremely low survival rate (as low as 5%) even after surgical resection [ 15 , 16 ]. For this reason, adjuvant chemotherapy (AC) is needed to improve the life expectancy of patients diagnosed in advanced stages [ 17 , 18 , 19 , 20 ].…”