Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun;89(6):636-641.
doi: 10.1136/jnnp-2017-317215. Epub 2018 Feb 8.

Incidence and disease burden of chemotherapy-induced peripheral neuropathy in a population-based cohort

Arya Shah  1 , E Matthew Hoffman  1 , Michelle L Mauermann  1 , Charles L Loprinzi  2 , Anthony J Windebank  1 , Christopher J Klein  1 , Nathan P Staff  1
Affiliations

Incidence and disease burden of chemotherapy-induced peripheral neuropathy in a population-based cohort

Arya Shah et al. J Neurol Neurosurg Psychiatry. 2018 Jun.

Abstract

Objective: To assess disease burden of chemotherapy-induced peripheral neuropathy (CIPN), which is a common dose-limiting side effect of neurotoxic chemotherapy. Late effects of CIPN may increase with improved cancer survival.

Methods: Olmsted County, Minnesota residents receiving neurotoxic chemotherapy were identified and CIPN was ascertained via text searches of polyneuropathy symptoms in the medical record. Clinical records were queried to collect data on baseline characteristics, risk factors, signs and symptoms of CIPN, medications, impairments and International Classification of Diseases, Ninth Revision (ICD-9) diagnostic codes for all subjects.

Results: A total of 509 individuals with incident exposure to an inclusive list of neurotoxic chemotherapy agents between 2006 and 2008 were identified. 268 (52.7%) of these individuals were determined to have CIPN. The median time from incident exposure to first documented symptoms was 71 days. Patients with CIPN received a neuropathy ICD-9 diagnosis in only 37 instances (13.8%). Pain symptoms and use of pain medications were observed more often in patients with CIPN. Five-year survival was greater in those with CIPN (55.2%) versus those without (36.1%). Those with CIPN surviving greater than 5 years (n=145) continued to have substantial impairments and were more likely to be prescribed opioids than those without CIPN (OR 2.0, 1.06-3.69).

Conclusions: Results from our population-based study are consistent with previous reports of high incidence of CIPN in the first 2 years following incident exposure to neurotoxic chemotherapeutic agents, and its association with significant pain symptomatology and accompanied long-term opioid use. Increased survival following exposure to neurotoxic chemotherapy and its long-term disease burden necessitates further study among survivors.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flowchart of epidemiological study of chemotherapy-induced peripheral neuropathy (CIPN) in Olmsted County, Minnesota (2006–2008).
Figure 2
Figure 2
Time-to-event curve demonstrating time from incident neurotoxic chemotherapy exposure to onset of signs or symptoms of CIPN.
Figure 3
Figure 3
Kaplan-Meier survival curve demonstrating improved 5-year survival among subjects that developed CIPN (p<0.0001).
See this image and copyright information in PMC

Comment in

References

    1. Staff NP, Grisold A, Grisold W, Windebank AJ. Chemotherapy-induced peripheral neuropathy: A current review. Ann Neurol. 2017 Jun;81(6):772–81. - PMC - PubMed
    1. Bao T, Basal C, Seluzicki C, Li SQ, Seidman AD, Mao JJ. Long-term chemotherapy-induced peripheral neuropathy among breast cancer survivors: prevalence, risk factors, and fall risk. Breast Cancer Res Treat. 2016 Sep;159(2):327–33. - PMC - PubMed
    1. Zanville NR, Nudelman KN, Smith DJ, et al. Evaluating the impact of chemotherapy-induced peripheral neuropathy symptoms (CIPN-sx) on perceived ability to work in breast cancer survivors during the first year post-treatment. Support Care Cancer. 2016 Nov;24(11):4779–89. - PMC - PubMed
    1. Kneis S, Wehrle A, Freyler K, et al. Balance impairments and neuromuscular changes in breast cancer patients with chemotherapy-induced peripheral neuropathy. Clin Neurophysiol. 2016 Feb;127(2):1481–90. - PubMed
    1. Tofthagen C, Overcash J, Kip K. Falls in persons with chemotherapy-induced peripheral neuropathy. Support Care Cancer. 2012 Mar;20(3):583–9. - PMC - PubMed

Publication types

Substances