Self-Reported Severity, Characteristics, and Functional Limitations of Chemotherapy-Induced Peripheral Neuropathy

Pain Manag Nurs. 2022 Aug;23(4):532-540. doi: 10.1016/j.pmn.2021.11.010. Epub 2021 Dec 28.

Abstract

Background: The early identification of chemotherapy-induced peripheral neuropathy (CIPN) (e.g., numbness or tingling in the fingers or toes) is important due to its frequency and the few effective treatment options available. The identification of common patient-reported CIPN characteristics and associated functional limitations may help to facilitate patient-clinician discussions of CIPN in practice.

Aims: To quantify the severity, duration, location, characteristics, and associated functional limitations of chemotherapy-induced peripheral neuropathy (CIPN) in patients receiving neurotoxic chemotherapy.

Design: Exploratory secondary analysis of a prospective, two-phase study SETTING: Breast, gastrointestinal, and multiple myeloma clinics at Dana-Farber Cancer Institute.

Participants: 142 individuals who planned to receive at least three more cycles of neurotoxic chemotherapy after consent.

Methods: Participants self-reported CIPN using standardized measures (i.e., PRO-CTCAE™ Numbness and Tingling Items or 0-10 numerical rating scale of worst CIPN pain intensity) and/or study team generated follow up questions about CIPN location, duration, characteristics, and functional limitations prior to three consecutive clinic visits (T1, T2, T3). Participants' responses to the CIPN self-report questionnaires were described by chemotherapy type and age.

Results: Over approximately 36.5 days (T1-T3), the percentage of participants reporting at least mild CIPN increased from 59.3% to 71%. At T3, patients with non-painful (n = 98) or painful neuropathy (n = 34) frequently reported symptoms in the fingers (non-painful = 83.5%, painful = 76.5%) or toes (non-painful = 49.5%, painful = 41.2%) and characterized symptoms as numbness (non-painful = 54.1%, painful = 50%) or tingling (non-painful = 68.4%, painful = 82.4%). Self-reported CIPN functional limitations (n = 55) included difficulties with buttoning a shirt (38.2%) or walking (25.5%). Paclitaxel-related CIPN (n = 33) was frequently characterized as "continuous" (30.3%), whereas oxaliplatin-related CIPN (n = 51) was frequently characterized as "intermittent" (41.2%). Young adults (15-39 years old, n = 15) frequently reported moderate-severe non-painful CIPN (46.7%), painful CIPN (40%), and CIPN interference (33.3%).

Conclusions: Consistent with qualitative research, participants frequently described CIPN as numbness and/or tingling in the fingers and/or toes.

Keywords: Neoplasms; Patient-Reported Outcome Measures; Peripheral Nervous System Diseases; Signs and Symptoms.

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Agents* / adverse effects
  • Humans
  • Hypesthesia / chemically induced
  • Hypesthesia / drug therapy
  • Peripheral Nervous System Diseases* / chemically induced
  • Prospective Studies
  • Self Report
  • Young Adult

Substances

  • Antineoplastic Agents