Long-Term Prevalence of Sensory Chemotherapy-Induced Peripheral Neuropathy for 5 Years after Adjuvant FOLFOX Chemotherapy to Treat Colorectal Cancer: A Multicenter Cross-Sectional Study.

Marie Selvy,Vincent Bourgeois,Denis Péré-Vergé,Cécile Leyronnas,Agnès Vimal-Baguet,Coralie Gonneau,Frédéric Thuillier,Vincent Pinon,Mohamed Ramdani,Ahmed Bedjaoui,Thibault Mazard,Florent Genty,Gabrielle Feydel,Jérôme Busserolles,Sharif Kullab,Denis Pezet,Florian Slimano,Floriane Huet-Penz,Bruno Pereira,Kheir Eddine Benmammar,David Balayssac,David Tavan,Brigitte Monange,Mohamed Hebbar,Olivier Bouché,Nicolas Kerckhove,Sophie Trévis ,S P Melnikov ,C Pétorin ,V Lebrun-Ly

doi:10.3390/jcm9082400

Abstract

(1) Background: Oxaliplatin is among the most neurotoxic anticancer drugs. Little data are available on the long-term prevalence and consequences of chemotherapy-induced peripheral neuropathy (CIPN), even though the third largest population of cancer survivors is made up of survivors of colorectal cancer. (2) Methods: A multicenter, cross-sectional study was conducted in 16 French centers to assess the prevalence of CIPN, as well as its consequences (neuropathic pain, anxiety, depression, and quality of life) in cancer survivors during the 5 years after the end of adjuvant oxaliplatin chemotherapy. (3) Results: Out of 406 patients, the prevalence of CIPN was 31.3% (95% confidence interval: 26.8–36.0). Little improvement in CIPN was found over the 5 years, and 36.5% of patients with CIPN also had neuropathic pain. CIPN was associated with anxiety, depression, and deterioration of quality of life. None of the patients with CIPN were treated with duloxetine (recommendation from American Society of Clinical Oncology), and only 3.2%, 1.6%, and 1.6% were treated with pregabalin, gabapentin, and amitriptyline, respectively. (4) Conclusions: Five years after the end of chemotherapy, a quarter of patients suffered from CIPN. The present study showed marked psychological distress and uncovered a failure in management in these patients.

Highlights

Oxaliplatin is a pivotal drug in the management of colorectal cancer
The proportions and visual analogue scale (VAS) scores of cold hypersensitivity were higher in patients with sensory chemotherapy-induced peripheral neuropathy (CIPN) than in those without (41.7% vs. 14.2%, p < 0.001; 49.0 ± 23.4 vs. 36.5 ± 22.4, p = 0.01, ES: 0.54, 95%confidence interval (CI): 0.12, 0.96)
CIPN has been related to cumulative oxaliplatin dose [4,5,6], but we found that cumulative dose was not related to CIPN risk, probably because our patients had globally a higher cumulative dose of oxaliplatin (1222.3 ± 455.6 mg/m2) than in previous studies (695 ± 273 mg/m2 and 553 ± 237 mg/m2) [5,6], which have been reviewed [4]

Summary

Introduction

Oxaliplatin is a pivotal drug in the management of colorectal cancer. Oxaliplatin-induced peripheral neuropathy is a disabling adverse drug reaction that interferes with patients’ quality of life [2]. This chemotherapy-induced peripheral neuropathy (CIPN) manifests itself in a typical stocking-glove pattern, with symptoms of paresthesia and dysesthesia, such as tingling, neuropathic pain, and numbness [2]. Oxaliplatin causes acute cold hypersensitivity during chemotherapy, which is a marker of its neurotoxicity This cold hypersensitivity decreases after the end of the chemotherapy [3]. Oncologists are frequently forced to decrease or discontinue oxaliplatin doses [12], which may have a negative impact on disease control and progression-free survival [13]

Objectives

Methods

Findings

Discussion

Conclusion