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

Abstract

AbstractObjectiveTo define the incidence and risk factors for developing chemotherapy‐induced neuropathic pain (CINP).MethodsRetrospective, 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.ResultsThe 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).ConclusionThe 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.