Upper-limb chemotherapy-induced peripheral neurotoxicity symptoms are common in patients post-cancer treatment and are associated with functional deficits and worse quality of life, Australian researchers have found.
They conducted a cross-sectional assessment of 60 participants who were 11.5 (IQR = 4.0–26.0) months post neurotoxic chemotherapy treatment (including taxanes, platinum-based agents, bortezomib, vinca alkaloids and thalidomide).
Participants (mean age 62, 73% female) had reported chemotherapy-induced peripheral neurotoxicity (CIPN) and were assessed using patient-reported and clinically-graded measures. Testing also included fine motor skills, sensory perception and neurophysiological measures of the median nerve.
Most patients had been diagnosed with gynaecological (40%), gastrointestinal (17%) or haematological cancers (20%), while the most common chemotherapy drugs administered were taxanes (57%) followed by platinum-based drugs (21%).
Almost two-thirds of the cohort reported upper-limb CIPN symptoms.
Of these, half reported numbness and tingling in the figures or hands, 33% reported only numbness, and 16% reported only tingling in the fingers or hands.
Only 15% of participants reported worse neuropathy severity in the upper-limb according to findings from qualitative interviews, while 73% of participants reported more severe lower-limb neuropathy and 12% reported equal severity.
Of the participants with upper-limb symptoms, 56% reported difficulty manipulating small objects with their fingers and 28% reported difficulties with writing.
Findings published in the Journal of the Neurological Sciences [link here] showed reduced sensory perception in the fingertips and reduced fine motor skills correlated with higher neurologically-graded CIPN severity. However, only reduced sensory perception in the fingertips correlated with patient-reported pain scores.
For the upper-limb symptom cohort specifically, reduced sensory perception was associated with worse neurologically-graded CIPN severity, said the authors from University of Sydney’s Brain and Mind Centre and Chris O’Brien Lifehouse.