Falls and Functional Impairments in Breast Cancer Patients with Chemotherapy-Induced Peripheral Neuropathy

Abstract

Objective: We investigated the incidence of falls and functional impairments in breast cancer patients with chemotherapy-induced peripheral neuropathy (CIPN). Additionally, we examined whether taxane-induced peripheral neuropathy was associated with the patients’ falls and functional impairments. Methods: We conducted a cross-sectional study including 88 patients with breast cancer who received taxane-based chemotherapy and were recognized as having peripheral neuropathy symptoms (Common Terminology Criteria for Adverse Events Grade ≥1). Patients completed the Functional Assessment of Cancer Therapy-Gynecologic Oncology Group-Neurotoxicity questionnaire for neuropathy and described falls from the onset of the taxane-based chemotherapy to the time of the survey. Functional impairments were defined using the Activities of Daily Living subsection of the Vulnerable Elder's Scale. Data were analyzed using descriptive statistics and logistic regression. Results: Of the participants, 40.9% experienced falls and 38.4% reported functional impairments. Most falls occurred on flat ground. Bone fracture due to falls was observed in 11.4% of the participants. Logistic regression revealed that CIPN was not significantly associated with the reported incidence of falls. However, it was significantly associated with functional impairments (odds ratio, 6.415; 95% confidence interval: 1.271–32.379; P = 0.024). Conclusions: CIPN was associated with functional impairments, but not with the incidence of falls. Patients should be informed prior to the onset of anticancer therapy that CIPN is a risk factor for functional impairments.

Occurrence of tinnitus and peripheral sensory neuropathy in women during chemotherapy treatment of breast cancer

“…Considering our findings and the available literature about chemotherapeutic agents related to the occurrence of CIPN, taxane agents (paclitaxel and docetaxel) have frequently been associated. The incidence of this condition in patients exposed to taxanes can vary from 11% to 83%, while in patients with breast cancer it can reach up to 70.8% 12 . The exact mechanisms by which taxane agents trigger neurotoxicity are still poorly understood.…”

“…Chemotherapy with paclitaxel or docetaxel in breast cancer is frequent and is indicated in the early phases or with metastatic tumors, showing the importance of these agents in this type of cancer 11,12 . In our findings, the presence of a taxane after the AC protocol (AC-T protocol) was associated with a more significant peripheral sensory neuropathy occurrence when these two protocols were compared.…”

“…In contrast, the absence of the taxane (AC protocol) was associated with a lower incidence than the multiprotocol group. Peripheral neuropathies associated with taxanes can manifest as bilateral paresthesias in the form of tingling, numbness, and pain associated with the burning sensation 12 . In contrast, those caused specifically by paclitaxel (predominant taxane agent in our sample) is associated with reduced quality of life and functional capacity of cancer survivors 11 , and restriction of daily activities 12 .…”

“…Besides, clinical and sociodemographic variables can influence the manifestation of CIPN, including age, diagnosis time, race, and associated drugs 9,10 . Several studies have been conducted to understand the genetic, functional, and pharmacological aspects of CIPN in patients [11][12][13][14] .…”

Role of Kinematics Assessment and Multimodal Sensorimotor Training for Motion Deficits in Breast Cancer Chemotherapy-Induced Polyneuropathy: A Perspective on Virtual Reality Avatars

“…Independent of the mechanisms of action, the targeted impact of such agents is on axonal transmission (1,23,24) with consequences leading up to neuronal apoptosis (25). CIPN generates sensory (26) as well as motor symptoms (27), with a high prevalence between 30 and 83% of the patients reporting persistent neuropathy, with 68.1% in <30 days following termination of the chemotherapy (6). Considering wider timescales, the average occurrence of CIPN was shown to be up to 28.7% in the first year after diagnosis, with more than 80% of the patients presenting symptoms after 6 months (28).…”