Longitudinal Study of Inflammatory, Behavioral, Clinical and Psychosocial Risk Factors for Chemotherapy-Induced Peripheral Neuropath

Abstract

Purpose. Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting side effect of taxane and platinum chemotherapy for breast cancer. Clinicians cannot accurately predict CIPN severity partly because its pathophysiology is poorly understood. Although inflammation may play a role in CIPN, there are limited human studies. Here, we identified the strongest predictors of CIPN using variables measured before taxane- or platinum-based chemotherapy, including serum inflammatory markers.Methods. 116 sedentary women with breast cancer (mean age 55 years) rated (1) numbness and tingling and (2) hot/coldness in hands/feet on 0-10 scales before and after six weeks of taxane- or platinum-based chemotherapy. A sub-study was added to collect cytokine data in the final 55 patients. We examined all linear models to predict CIPN severity at 6 weeks using pre-chemotherapy assessments of inflammatory, behavioral, clinical, and psychosocial factors. The final model was selected via goodness of fit.Results. The strongest pre-chemotherapy predictors of numbness and tingling were worse fatigue/anxiety/depression (explaining 27% of variance), older age (9%), and baseline neuropathy (5%). The strongest predictors of hot/coldness in hands/feet were worse baseline neuropathy (11%) and fatigue/anxiety/depression (6%). Inflammation was a risk for CIPN, per more pro-inflammatory IL-1β (6%) predicting numbness/tingling and less anti-inflammatory IL-10 predicting numbness and tingling (6%) and hot/coldness in hands/feet (9%).Conclusions. The strongest pre-chemotherapy predictors of CIPN included worse fatigue/anxiety/depression and baseline neuropathy. A pro-inflammatory state also predicted CIPN. Because this is an exploratory study, these results suggest specific outcomes (e.g., IL-1β) and effect size estimates for designing replication and extension studies.Trial Registration. NCT00924651

Symptom Clusters and Quality of Life in Patients With Lung Cancer Receiving Immunotherapy in China

“…Hence, the ndings indicated that there were no signi cant statistical disparities in the uence of neural symptom clusters on individuals' quality of life. Previous research suggested that fatigue, anxiety, and depressive symptoms can exacerbate neural symptom clusters [34]. Hence, it is recommended that healthcare practitioners prioritize the management of lung cancer-speci c symptom clusters and emotion-related symptom clusters with the aim of moderating neural symptom clusters.…”