Prevalence and predictors of peripheral neuropathy after chemotherapy: Outcomes from the Detroit Research on Cancer Survivorship (ROCS) cohort.

Abstract

12069 Background: Increased life expectancy for cancer survivors following advances in treatment has led to a greater likelihood of developing long-term complications. Among them is chemotherapy-induced peripheral neuropathy (CIPN), which adversely impacts the functional capacity of survivors. We assessed prevalence and predictors of CIPN in a cohort of African-American (AA) cancer survivors. Methods: The study population included 633 breast, colorectal, prostate and lung cancer survivors who received chemotherapy and participated in the Detroit Research on Cancer Survivorship (ROCS) study. Presence of CIPN was based on self-reported pain, numbness or tingling in the hands or feet, occurring either for the first time or worsening after chemotherapy. If participants reported continued CIPN at the time of survey, their symptoms were reported as persistent. CIPN severity was self-reported as mild, moderate or severe. Logistic regression analysis was used to evaluate socio-demographic and clinical factors (including 12 common comorbid conditions) associated with CIPN prevalence, persistence and severity. Results: Overall, 67% of the cohort reported CIPN at a mean time of 25.3 months (range 2-74 months) after cancer diagnosis, and 51% reported persistent CIPN. The distribution of CIPN severity consisted of 32.2% with mild, 30.8% with moderate, and 36.9% with moderate to severe symptoms. Diagnosis of primary breast (OR 3.99, 95% CI 1.52-10.46) or colorectal cancers (OR 5.24, 95% CI 2.17-12.69) conferred greater CIPN prevalence relative to a diagnosis of prostate cancer. The presence of each additional comorbid condition among those outlined in the survey also conferred a 20% greater prevalence of CIPN (OR 1.2, 95% CI 1.03-1.39). Similar trends were seen among those who reported persistent CIPN. Using age > 65 at diagnosis as the reference group, age < 50 (OR 2.64, 95% CI 1.43-4.88) and age 51-64 (OR 1.96, 95% CI 1.14-3.35) resulted in an increased risk of moderate or severe compared to mild CIPN. Conclusions: In the Detroit ROCS cohort, CIPN was reported in two-thirds of cancer survivors receiving chemotherapy. Out of them, more than one-third reported moderate to severe symptoms, more commonly seen among those age < 65. Consideration of CIPN as a prominent long-term complication of cancer treatment should play a role in treatment decisions and development of new chemotherapy regimens.