Chemotherapy-Induced Peripheral Neuropathy: A Review and Implications for Oncology Nursing Practice

Abstract

Advances in supportive care have increased the likelihood that previously less common adverse effects of chemotherapy will be more evident. The incidence of chemotherapy-induced peripheral neuropathy (CIPN) is increasing because more neurotoxic drugs have been developed and because patients are living longer and receiving multiple chemotherapy regimens. This article reviews the anatomy of the peripheral nervous system, the proposed mechanisms of CIPN, and manifestations of CIPN from vinca alkaloids, taxanes, and platinum analogs. Major topics of this article are evidence-based data regarding symptom management, a review of medical management, and a synthesis of nursing care for patients at risk for or experiencing CIPN.

Relationship between Chemotherapy-induced Peripheral Neuropathy and Quality of Life in Patients with Hematologic Malignancies

“…And, the mean CIPN scores for the lower and upper extremity scales as in this study were 31.95 and 23.16 points, respectively, demonstrating more severe CIPN-related symptoms in the lower extremities. These results are similar to those of previous studies [1,27], which CIPN-related symptoms were more frequent and intense in the lower extremities than in the upper extremities. Patients experiencing peripheral neuropathy from the administration of neurotoxic chemotherapeutic agents with severe symptoms in the lower extremity are at high risk of falling, calling for safe, prudent nursing care.…”

“…But, CIPN symptoms in the upper extremities showed no correlation with quality of life. It is considered that these results are shown because CIPN symptoms appear more often, sooner and more severely in lower extremities compared than upper extremities [1,27]. Also, as the degradation in the sensory and motor functions of lower extremities induced difficulties in driving, walking, exercising, or engaging in any activity that requires mobility or balance [3], it is considered that such dysfunction has affected qualify of life.…”

“…Cancer patients treated with neurotoxic chemotherapeutic agents may develop chemotherapy-induced peripheral neuropathy (CIPN) [1]. Comprised of motor, sensory, and/or autonomic neuron dysfunction and resulting in peripheral neuropathic signs [2], indolent symptoms of CIPN include numbness, loss of postural balance, muscle weakness, tingling, systemic weakness, and concentration disorders.…”

Reliability and Validity of the Korean Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire to Assess Chemotherapy-induced Peripheral Neuropathy

“…Although such grading scales are effective, they are limited because they are uni-dimensional in nature and lack sensitivity and specificity [10][11][12]. Instruments used to evaluate neuropathic symptoms, such as the Total Neuropathy Scale, the Neuropathy Symptom Profile, and the Neurological Disability Score, do not provide information on severity, distress, timing, or impacts on daily activities [2].…”

Complications of Multiple Myeloma Therapy, Part 1: Risk Reduction and Management of Peripheral Neuropathy and Asthenia

“…1,5,9,13,[15][16][17][18][19][20][21] Most cases are mild to moderate, classified as grades 1 to 2 (Table 1). 22 Evidence from numerous studies indicates that the risk and severity of thalidomide-induced PN increases with cumulative dose or treatment duration, particularly when therapy extends beyond 6 months, 1,5,7,[15][16][17]19,23 although neurotoxicity can also occur with short-term exposure.…”