Painful and non-painful chemotherapy-induced peripheral neuropathy and quality of life in colorectal cancer survivors: results from the population-based PROFILES registry

C S Bonhof,H R Trompetter,G Vreugdenhil,L V Van De Poll-Franse,F Mols

doi:10.1007/s00520-020-05438-5

Abstract

PurposeThis study aims to (1) examine the prevalence of painful versus non-painful chemotherapy-induced peripheral neuropathy (CIPN) among long-term colorectal cancer (CRC) survivors, (2) identify sociodemographic, clinical, and psychological factors associated with painful and non-painful CIPN, and (3) examine the associations of painful CIPN with health-related quality of life (HRQoL) in comparison with non-painful CIPN, i.e., numbness/tingling.MethodsAll CRC survivors diagnosed between 2000 and 2009 as registered by the population-based Netherlands Cancer Registry (Eindhoven region) were eligible for participation. Chemotherapy-treated survivors (n = 477) completed questions on CIPN (EORTC QLQ-CIPN20) and HRQoL (EORTC QLQ-C30).ResultsPainful CIPN was reported by 9% (n = 45) of survivors and non-painful CIPN was reported by 22% (n = 103). Time since diagnosis was related to painful CIPN, and time since diagnosis, a higher disease stage, osteoarthritis, and more anxiety symptoms were related to non-painful CIPN. Finally, survivors with painful CIPN reported a worse global quality of life and worse physical, role, cognitive, and social functioning compared to survivors with non-painful CIPN and those without any sensory CIPN. No differences were found between survivors with non-painful CIPN and those without sensory CIPN.ConclusionsIt seems that painful CIPN must be distinguished from non-painful CIPN, as only painful CIPN was related to a worse HRQoL. Future research is needed to examine whether painful CIPN must be distinguished from non-painful CIPN regarding predictors, mechanisms, and treatment.

Highlights

Chemotherapy has contributed significantly to the increased survival rates in colorectal cancer (CRC) [1]
Severe numbness and tingling commonly exist without neuropathic pain symptoms, while the reverse is not common [7, 8]. These findings indicate that painful chemotherapyinduced peripheral neuropathy (CIPN) must be evaluated separately from non-painful CIPN symptoms, such as numbness and tingling
In the previous PROFILES study using the same sample as the current study [5], we found that survivors treated with chemotherapy only reported more shooting/burning pain, numbness, and tingling compared to survivors not treated with chemotherapy

Summary

Introduction

Chemotherapy has contributed significantly to the increased survival rates in colorectal cancer (CRC) [1]. Patients frequently live with the long-term side effects of this treatment. Chemotherapeutic agents commonly used in the treatment of CRC are highly toxic to the peripheral nervous system. Patients often develop chemotherapyinduced peripheral neuropathy (CIPN) [2]. CIPN most commonly presents as sensory neuropathy, with symptoms such as tingling, numbness, and burning pain in the hands or feet in a characteristic stocking-glove distribution [2]. There are currently no agents available for the prevention or treatment of CIPN, and so, dose reduction and even cessation of treatment are often necessary to prevent severe CIPN. CIPN symptoms often improve or even disappear, but it is a chronic issue for about 30% of patients [3]

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