Clinical Predictors And Levels Of Physical Activity Among Cancer Survivors Treated With Neurotoxic Chemotherapy

Abstract

PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side-effect for cancer survivors and may negatively impact on physical activity (PA). The primary aim of our study was to descriptively quantify PA levels among cancer survivors treated with neurotoxic chemotherapy regimens. Our secondary aims: 1) investigated the proportion of survivors with CIPN symptoms interfering with PA participation, and 2) investigated CIPN-related predictors of walking and moderate-vigorous PA. METHODS: 361 participants were assessed cross-sectionally post-neurotoxic chemotherapy (68% female, median (IQR) age 59.5 (50-68) years, 12 (6-24) months post-treatment completion). PA was self-reported (IPAQ) and classified as meeting recommended moderate-vigorous PA guidelines (≥150 minutes/week) or not. CIPN severity (NCI-CTCAE, FACT/GOG-Ntx13), sural and tibial nerve conduction studies, and balance (Swaymeter) were assessed. RESULTS: 47% of participants did not meet recommended PA guidelines. 25% did not participate in any moderate-vigorous PA. 71% presented with CIPN symptoms (≥grade 1 NCI). 25% reported that their CIPN symptoms interfered with PA, who had impaired balance (p = .02), but not reduced sural (p = .10) or tibial nerve (p = .17) nerve amplitudes. Univariate analyses identified that survivors aged ≥60, with grade ≥ 1 NCI CIPN, diagnosed with stage III/IV disease or were obese were less likely to meet PA guidelines (all p < .05), although regression models identified older age, higher BMI and female sex were associated with lower levels of walking and moderate-vigorous PA. CONCLUSIONS: Many cancer survivors exposed to neurotoxic chemotherapy have low PA levels. Female cancer survivors, who are older, and with higher BMIs are less likely to participate in walking and moderate-vigorous PA post-neurotoxic chemotherapy. Tailored interventions are needed to increase PA in this population to improve physical function and quality of life.