Abstract
Oxaliplatin, a pivotal drug in the management of colorectal cancer, causes chemotherapy-induced peripheral neuropathy (CIPN) in a third of cancer survivors. Based on a previous cross-sectional study assessing oxaliplatin-related sensory CIPN in colorectal cancer survivors, a secondary analysis was designed to explore the possibility that different clusters of patients may co-exist among a cohort of patients with oxaliplatin-related CIPN. Other objectives were to characterize these clusters considering CIPN severity, anxiety, depression, health-related quality of life (HRQOL), patients’ characteristics and oxaliplatin treatments. Among the 96 patients analyzed, three clusters were identified (cluster 1: 52, cluster 2: 34, and cluster 3: 10 patients). Clusters were significantly different according to CIPN severity and the proportion of neuropathic pain (cluster 1: low, cluster 2: intermediate, and cluster 3: high). Anxiety, depressive disorders and HRQOL alteration were lower in cluster 1 in comparison to clusters 2 and 3, but not different between clusters 2 and 3. This study underlines that patients with CIPN are not a homogenous group, and that CIPN severity is associated with psychological distress and a decline of HRQOL. Further studies are needed to explore the relation between clusters and CIPN management.
Highlights
Oxaliplatin is a key anticancer drug in the management of colorectal cancer
A multiple correspondence analysis (MCA), which can be considered as a generalization of principal component analysis for categorical rather than quantitative variables, was applied to study the associations between the sociodemographic and chemotherapy characteristics of the patients, QLQ-CIPN20, neuropathic pain, anxiety, depression and health-related quality of life (HRQOL)
Among the initial 127 patients with an oxaliplatin-related chemotherapy-induced peripheral neuropathy (CIPN) (Selvy et al, 2020), 96 patients were included and 31 excluded because of data missing from any of the variables selected for the analysis (Figure 1)
Summary
Oxaliplatin is a key anticancer drug in the management of colorectal cancer. Oxaliplatin is one of the most neurotoxic anticancer drugs and responsible for chemotherapy-induced peripheral neuropathy (CIPN). Oxaliplatin induces acute neuronal hyperexcitability, occurring shortly after infusion, mainly characterized by cold hypersensitivity of the distal extremities and of the orofacial area (Gebremedhn et al, 2018). This acute neurotoxicity can affect up to 98% of patients (Gebremedhn et al, 2018). Oxaliplatin-associated CIPN has persisted for several years after the end of treatment in several cancer survivors (5 years after the end of chemotherapy: 31.3% [95% confidence interval (CI): 26.8; 36.0]), and is associated with psychological distress, a decrease of health-related quality of life (HRQOL) (Selvy et al, 2020) and a greater risk of patients falling, with all the negative consequences that can result from this (Kolb et al, 2016)
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