Late Effects of Oxaliplatin-induced peripheral Neuropathy (LEON) (#179)
Peripheral neuropathy is a common adverse effect of oxaliplatin based chemotherapy. This can become a long-term toxicity. We evaluated the incidence and severity of chronic oxaliplatin-induced peripheral neuropathy in a consecutive cohort of patients that has been treated with oxaliplatin at least 2 years previously. We compared perceived to objective measures of severity of peripheral neuropathy. We also explored patient perceptions of the impact of neuropathy.
A cross-sectional observational study of patients who received oxaliplatin at Flinders Medical Centre and Flinders Private Hospital during 2000-2009. All patients had received treatment at least 2 years prior to study entry. This study comprised of 3 components;
1. Nerve conduction studies,
2. Quality of life (QoL) assessments (HADS, WHOQOL, EQ-5D questionnaire and CIPN20-QOL),
3. Patient interview
39 eligible patients were identified and 25 patients consented to participate. The mean cumulative dose of oxaliplatin was 1585.33mg for 14 patients with chronic peripheral neuropathy (CPN) symptoms. 22 patients reported neuropathy during treatment and 14 continued to have CPN: 7 patients had Common Terminology Criteria for Adverse Event (CTCAE) grade I CPN, 3 had grade II and 4 had grade III.
QoL assessment showed physical domain scores at 69%. There was no statistical correlation between patient reported CPN and QoL scores. The mean CIPN20 neuropathic score was 35 for those living with CPN, compared to score of 21 without CPN. The mean EQ-5D functional assessment score was 7.88, compared to minimum score of 5.
Objective modified total neuropathy scores (TNS) ranged from 1 to 15. The mean modified TNS was 9.54. There was a statistically significant correlation between cumulative oxaliplatin dose and modified total neuropathy score (p=0.023 CI=0.353).
Qualitative analysis of LEON study will be discussed separately.
56% of oxaliplatin pre-treated cancer survivors reported ongoing peripheral neuropathy more than 2 years following chemotherapy. Neuropathic symptom scales and QoL measures showed varying degrees of biopsychosocial functions.