Falls, physical performance deficits, and functional losses in cancer survivors with chemotherapy-induced neuropathy (CIPN): A University of Rochester CCOP study.

Abstract

9014 Background: CIPN impairs quality of life in cancer survivors. Little is known about the prevalence of falls, physical performance (PP) deficits, and functional losses or their association with CIPN toxicities in cancer survivors. Methods: We conducted an analysis of baseline assessments from a phase III randomized clinical trial in cancer survivors with CIPN self reported pain scores of > 4 reflecting leg and foot pain from neuropathy over the past 24 hours on a scale from 0 (“no pain”) to 10 (“pain as bad as you can imagine”). Patients also completed EORTC QLQ-CIPN-20 sensory and motor scales for neuropathy toxicities and self reported falls in the previous 3 months. A PP deficit was defined as “a lot of difficulty” or “unable to do” any of 6 physical tasks (e.g., lifting objects, walking a quarter of a mile). Functional losses were defined as “a lot of difficulty” or “unable to do” any of 5 functional tasks (e.g., managing money, bathing). We examined the association of baseline characteristics and CIPN toxicities with falls, PP deficits and functional losses using logistic regression. Results: Of 421 patients, 11.9% experienced recent falls, 58.6% reported a PP deficit, and 26.6% reported a functional loss. Patients with falls and/or PP deficits were more likely to be older (mean age 60.9 vs 58.9, p=0.02), female (75.3% vs 65.2%, p=0.03) and have less education (<high school: 7.1% vs 0.6%, p<.01). Cancer and chemotherapy history were not different between groups. Patients with falls and/or PP deficits reported higher severity of CIPN toxicities: pain (6.82 vs 6.05, p<0.01), sensory (23.3 vs 19.6, p<0.01), and motor (17.4 vs 12.7, p<0.01). In multivariable analysis, factors associated with having a fall and/or PP deficit included: older age (OR 1.03, p=0.04), low education (OR 9.34, p=0.04), and motor toxicity (OR 1.21, p<0.01). Factors associated with functional losses included: non-white race (OR 3.16, p=0.01), Hispanic ethnicity (OR 5.32, p=0.05), motor toxicity (OR 1.19, p<0.01), and PP deficit (OR 4.94, p<.01). Conclusions: CIPN toxicities, primarily motor, are significantly associated with falls, physical performance deficits, and functional losses.