Mapping chemotherapy-induced peripheral neuropathy phenotype and health-related quality of life in patients with cancer through exploratory analysis of multimodal assessment data.

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of anticancer treatment based on neurotoxic agents, which may affect function and health-related quality of life (HRQoL) in patients with cancer. This exploratory study aimed to identify the phenotype of CIPN and examine the association of CIPN with general symptoms and HRQoL in patients with cancer. A secondary analysis was performed on the baseline multimodal assessment data of 87 patients with cancer who participated in a randomized trial examining the effectiveness of an 8-week acupuncture protocol in managing CIPN. The data used for this study include patient-reported CIPN, general symptoms, and HRQoL, neurological examinations, and clinician-based grading of CIPN. Descriptive statistics, non-parametric tests, and hierarchical cluster analysis were used for data analysis. Patients with CIPN experienced a series of symptoms, with numbness, tingling, and discomfort in the hands and feet being the most prominent descriptors pertaining to CIPN. Increased severity of CIPN was associated with higher distress from general symptoms and lower physical well-being. These CIPN-specific and general symptoms formed five independent symptom clusters, includingtwo sensory neuropathy symptom clusters, a sensorimotor neuropathy one, a neuro-psychological one, and an autonomic symptom cluster. Painful CIPN was significantly associated with higher symptom burden, lower physical well-being, and impaired tendon reflex. No significant difference was found between type of neurotoxic agents in symptom burden, neurological signs, and HRQoL. Researchers and clinicians should pay attention to the characteristics and impact of CIPN from multiple aspects, so as to develop targeted interventions to meet patients' holistic needs. Painful CIPN warrants particular attention as it is associated with higher symptom burden and lower physical well-being in patients with cancer.