Incidence and risk factors for developing chemotherapy-induced neuropathic pain in 500 cancer patients: A file-based observational study

IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Journal of the Peripheral Nervous System Pub Date : 2024-02-04 DOI:10.1111/jns.12616
Andreas A. Argyriou, Jordi Bruna, Foteini Kalofonou, Roser Velasco, Pantelis Litsardopoulos, Montse Alemany, Garifallia G. Anastopoulou, Haralabos P. Kalofonos
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Abstract

Objective

To define the incidence and risk factors for developing chemotherapy-induced neuropathic pain (CINP).

Methods

Retrospective, file-based analysis on cancer patients who received any type of conventional chemotherapy and for whom neurological evaluation was asked to reveal the extent of chemotherapy-induced peripheral neurotoxicity (CIPN) with or without CINP. CINP was assessed by means of the PI-NRS and Douleur Neuropathique-4 questionnaire. The total neuropathy score-clinical version graded the severity of CIPN.

Results

The medical files of 500 chemotherapy-treated cancer patients were reviewed. Any grade chronic CIPN was disclosed in 343 (68.6%) patients and CINP in 127 (37%) of them, corresponding to an overall percentage of 25.4% among all 500 included patients. The logistic regression analysis identified as independent predictors for CINP development the presence of uncomplicated diabetes (OR: 2.17; p = .039) and grade 2–3 chronic CIPN (OR: 1.61; p < .001) as also the administration of combined paclitaxel plus cisplatin (reference variable), compared to oxaliplatin (OR: 0.18; p = .001) and taxanes (OR: 0.16; p < .001). The increased severity of acute OXAIPN was associated with CINP (OR: 4.51; p < .001). OXA-treated patients with persistent CINP presented a worst likelihood to improve after chemotherapy discontinuation, than patients receiving combined paclitaxel plus cisplatin (OR: 50; p < .001).

Conclusion

The incidence of CINP in our cohort was comparable to previous reports, with severities fluctuating upwards during chemotherapy and declined post-chemotherapy. Uncomplicated diabetes, the combined paclitaxel plus cisplatin treatment and the increased severity of acute oxaliplatin neurotoxicity mostly increase the risk for developing CINP. OXA-treated patients present less possibilities to recover from CINP after chemotherapy discontinuation, than other chemotherapies.

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500 名癌症患者化疗所致神经病理性疼痛的发生率和风险因素:基于档案的观察研究。
目的:确定化疗诱发神经病理性疼痛(CINP)的发病率和风险因素:明确化疗诱发神经病理性疼痛(CINP)的发病率和风险因素:对接受过任何类型常规化疗的癌症患者进行回顾性档案分析,并对其进行神经学评估,以了解化疗诱发周围神经毒性(CIPN)的程度,以及是否伴有 CINP。CINP 通过 PI-NRS 和 Douleur Neuropathique-4 问卷进行评估。神经病变总分-临床版对 CIPN 的严重程度进行分级:结果:对 500 名接受化疗的癌症患者的医疗档案进行了审查。343例(68.6%)患者被发现患有任何等级的慢性CIPN,其中127例(37%)被发现患有CINP,在所有500例患者中的总比例为25.4%。逻辑回归分析发现,无并发症糖尿病(OR:2.17;P = .039)和 2-3 级慢性 CIPN(OR:1.61;P 结论:本研究中的 CINP 发生率与无并发症糖尿病(OR:2.17;P = .039)和 2-3 级慢性 CIPN(OR:1.61;P = .039)呈正相关:我们队列中的 CINP 发生率与之前的报告相当,严重程度在化疗期间向上波动,化疗后有所下降。无并发症的糖尿病、紫杉醇加顺铂的联合治疗以及急性奥沙利铂神经毒性的严重程度增加,都会增加罹患 CINP 的风险。与其他化疗方法相比,接受 OXA 治疗的患者在停止化疗后从 CINP 中恢复的可能性较小。
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来源期刊
CiteScore
6.10
自引率
7.90%
发文量
45
审稿时长
>12 weeks
期刊介绍: The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders. The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies. Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials. The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.
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