Prevalence, Severity, and Persistence of Chemotherapy-Induced Peripheral Neuropathy in Early-Stage Breast Cancer Patients Treated with Paclitaxel: an Observational Study in a Referral Hospital in Latin America

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the main adverse effects of antitumor treatment. The aim of our study was to examine the prevalence and severity of CIPN in breast cancer patients treated with paclitaxel. The association with specific patient-, tumour- and treatment-related variables was also explored. Thus, 45 patients with early-stage breast cancer were evaluated at a referral hospital in Argentina. Patient-reported CIPN-related symptoms were assessed using an abbreviated version of EORTC QLQ-CIPN20 questionnaire. Additional variables analyzed included age, weight, body mass index, tumor phenotype, and chemotherapy regimen. The study population included women aged 25-71 years. Most tumors were ER/PR-positive, and the most frequently used chemotherapy regimen was adjuvant anthracycline-based therapy. The prevalence of clinical CIPN, defined by the presence of at least one symptom experienced ‘quite a bit’ or ‘very much’, was 62%. In contrast, clinical records showed a prevalence of 24%. No significant associations were observed between patient-, tumor- or treatment-related variables and CIPN development. Among patients with neuropathy, mean CIPN score was 26,25. Of these patients, 50% presented both sensory and motor symptoms, 29% only motor and 18% only sensory symptoms. Two years after finishing chemotherapy, 46% of CIPN-patients still experienced at least one symptom. All patients with persistent symptoms had experienced motor disturbances during chemotherapy, with significantly higher motor scores. Our results indicate a high prevalence of CIPN-related symptoms during and after paclitaxel administration in our population. The presence and/or the severity of motor symptoms during chemotherapy could be postulated as possible predictors of CIPN persistence. Clinical underreporting and symptom persistence emphasize the need to incorporate patient-reported measures into clinical practice to better detect symptoms and guide interventions to improve patient’s quality of life.