Chemotherapy-induced peripheral neuropathy as a predictor of neuropathic pain in breast cancer patients previously treated with paclitaxel.

Abstract

UNLABELLED:

Neuropathic pain (NP) remains difficult to control for a significant number of patients with cancer. Chemotherapy-induced peripheral neuropathy (CIPN) has been postulated as an initial stage in the development of NP. To assess whether CIPN (defined as National Cancer Institute Common Toxicity Criteria grade 2 or higher) was associated with NP, we conducted a survey of breast cancer patients who had participated in clinical trials of paclitaxel. Of the 430 potential respondents, 240 responded to the survey. Results showed that 64% experienced CIPN during paclitaxel treatment. Follow-up survey data revealed that 27% of those with CIPN were subsequently diagnosed with NP. Logistic regression analyses showed that those who had experienced CIPN were 3 times more likely to develop NP (95% confidence interval = 1.2-7.2; P < .001), which persisted in the multivariate logistic model. In addition, NP patients reported twice as many visits to their health care provider (P = .02) and had taken more prescription (50% vs 19%; P = .001) and over-the-counter medications (62.5% versus 45%; P = .08) for pain than those without NP. The results of this study confirm that CIPN is a predictor of NP, suggesting that survivors treated with paclitaxel should be regularly monitored for NP beyond treatment.

PERSPECTIVE:

The survival rates of breast cancer patients have steadily improved over recent years; thus, research into symptoms that persist after treatment is important. We found CIPN as a predictor of NP. Understanding the epidemiology of NP in breast cancer patients has high clinical and public health significance.

• Authors: Cielito C Reyes-Gibby, Phuong Khang Morrow, Aman Buzdar, Sanjay Shete
• Journal: The journal of pain (J Pain) Vol. 10 Issue 11 Pg. 1146-50 (Nov 2009) ISSN: 1528-8447 [Electronic] United States
• PMID: 19595634 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Analgesics
• Antineoplastic Agents, Phytogenic
• Paclitaxel

Topics

• Analgesics (therapeutic use)
• Analysis of Variance
• Antineoplastic Agents, Phytogenic (adverse effects, therapeutic use)
• Breast Neoplasms (complications, drug therapy, epidemiology)
• Comorbidity
• Female
• Follow-Up Studies
• Humans
• Logistic Models
• Multivariate Analysis
• Neuralgia (diagnosis, drug therapy, epidemiology, etiology)
• Odds Ratio
• Paclitaxel (adverse effects, therapeutic use)
• Patient Acceptance of Health Care
• Peripheral Nervous System Diseases (chemically induced, epidemiology)
• Risk Factors