Abstract
Background Prevalence of peripheral neuropathy (PN) has been studied in patients undergoing treatment with taxanes, platinums and vinca alkaloids. The prevalence is unknown in the general oncological cancer population, characterized by advanced age, comorbidities and heterogeneous treatments. Material and Methods A cross-sectional survey was administered to all adult patients, attending outpatient services at three Danish departments of oncology. The survey contained the EORTC-CIPN20, the EORTC-QLQ-C30, the GAD7 and PHQ9 questionnaires. A high PN symptom score was defined as a summary score ≥30 points on the CIPN20. P-values were adjusted for multiple testing. Results With an overall response rate of 83% (2839 patients), prevalence of PN was 17% overall, varying from 6 to 33% between diagnosis groups. A high score was more common among females (19 vs. 14%, p = .008), smokers (21 vs. 15%, p = .04), patients living alone (21 vs. 15%, p = .002) and patients using cannabis (29 vs. 15%, p < .001), as well as patients suffering from diabetes (26 vs. 16%, p < .001), cardiac heart disease (27 vs. 16%, p < .001), arthritis (32 vs. 15%, p < .001) or chronic obstructive pulmonary disease (25 vs. 16%, p = .01). High score patients were also older (69ys vs 67ys, p = .048) and more likely experiencing polypharmacy (OR = 3.38 [95% CI, 2.64;4.35]). Patients with a high CIPN20 symptom score scored worse on all EORTC QLQ-C30 function and symptom scales. The mean adjusted C30 SumScore difference was −18.66 ([95% CI, −20.31; −17.02], p < .001). Conclusion Symptoms of PN are experienced widely across cancer groups in the oncology setting. PN symptoms were associated with clinically relevant worse health-related quality of life and with patient-related factors as living alone, various comorbidities, polypharmacy, and cannabis use.
Highlights
During the last five decades, combination chemotherapy has been used to increase the survival of patients with cancer and many treatment regimens include neurotoxic components [1]
Symptoms of peripheral neuropathy (PN) are experienced widely across cancer groups in the oncology setting and symptoms are correlated with patient-related factors as living alone, various comorbidities, polypharmacy, and cannabis use
For instance we found a higher proportion of women in the high score group, while other studies found Chemotherapyinduced peripheral neuropathy (CIPN) distributed between genders [24, 31], but most research on CIPN has been conducted on cohorts of one gender [3, 26, 30]
Summary
During the last five decades, combination chemotherapy has been used to increase the survival of patients with cancer and many treatment regimens include neurotoxic components [1]. Chemotherapyinduced peripheral neuropathy (CIPN) is the most prevalent type of cancer-related peripheral neuropathy (PN) experienced by up to 37–84% of patients three months after ending treatment [2]. Oncology PN estimates are specific for cancer patient subgroups only [2] and affected by limitations, including – but not limited to – misestimating/neglecting prevalence of motor- and autonomous neuropathy [7, 9], overrepresentation of homogenous datasets from uniform patient trajectories i.e. patients receiving neurotoxic chemotherapy in the adjuvant settings [2] and using data from before the era of immunotherapy and biological agents [2, 3], which can induce PN [10]
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