Chemotherapy-induced
peripheral neuropathy (CIPN) is a dose-limiting adverse reaction in
cancer patients treated with several cytotoxic
anticancer agents including
paclitaxel.
Duloxetine, an
antidepressant known as a
serotonin-noradrenalin reuptake inhibitor, is the only agent that has moderate evidence for the use to treat painful CIPN. The present retrospective cohort study aimed to analyze risk factors for
paclitaxel-induced
peripheral neuropathy (PIPN), and investigate ongoing
prescription drug use for PIPN in Japan. Female breast and gynecologic
cancer patients who underwent
paclitaxel-based
chemotherapy at a single center in Japan between January 2016 and December 2019 were enrolled in this study. Patients' information obtained from electronic medical records were statistically analyzed to test possible risk factors on PIPN diagnosis. Patients' age, total
paclitaxel dose, the history of female
hormone-related diseases,
hypertension and body mass index (BMI), but not additional
platinum agents, were significantly associated with increased PIPN diagnosis. Drugs prescribed for PIPN included
duloxetine,
pregabalin,
mecobalamin and
Goshajinkigan, a polyherbal medicine, regardless of poor evidence for their effectiveness against CIPN, and were greatly different between breast and gynecologic
cancer patients diagnosed with PIPN at the departments of Surgery and Gynecology, respectively. Thus, older age, greater total
paclitaxel dose, the history of
estrogen-related diseases,
hypertension and BMI are considered risk factors for PIPN in
paclitaxel-based
chemotherapy of female
cancer patients. It appears an urgent need to establish a guideline of evidence-based
pharmacotherapy for PIPN.