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. 2020 Jul 27;9(8):2400.
doi: 10.3390/jcm9082400.

Long-Term Prevalence of Sensory Chemotherapy-Induced Peripheral Neuropathy for 5 Years after Adjuvant FOLFOX Chemotherapy to Treat Colorectal Cancer: A Multicenter Cross-Sectional Study

Marie Selvy  1 , Bruno Pereira  2 , Nicolas Kerckhove  1 , Coralie Gonneau  3 , Gabrielle Feydel  2 , Caroline Pétorin  4 , Agnès Vimal-Baguet  4 , Sergey Melnikov  5 , Sharif Kullab  6 , Mohamed Hebbar  7 , Olivier Bouché  8 , Florian Slimano  9 , Vincent Bourgeois  10 , Valérie Lebrun-Ly  11 , Frédéric Thuillier  11 , Thibault Mazard  12 , David Tavan  13 , Kheir Eddine Benmammar  14 , Brigitte Monange  14 , Mohamed Ramdani  15 , Denis Péré-Vergé  16 , Floriane Huet-Penz  17 , Ahmed Bedjaoui  18 , Florent Genty  19 , Cécile Leyronnas  20 , Jérôme Busserolles  3 , Sophie Trevis  21 , Vincent Pinon  21 , Denis Pezet  22 , David Balayssac  1
Affiliations

Long-Term Prevalence of Sensory Chemotherapy-Induced Peripheral Neuropathy for 5 Years after Adjuvant FOLFOX Chemotherapy to Treat Colorectal Cancer: A Multicenter Cross-Sectional Study

Marie Selvy et al. J Clin Med. .

Abstract

(1) Background: Oxaliplatin is among the most neurotoxic anticancer drugs. Little data are available on the long-term prevalence and consequences of chemotherapy-induced peripheral neuropathy (CIPN), even though the third largest population of cancer survivors is made up of survivors of colorectal cancer. (2) Methods: A multicenter, cross-sectional study was conducted in 16 French centers to assess the prevalence of CIPN, as well as its consequences (neuropathic pain, anxiety, depression, and quality of life) in cancer survivors during the 5 years after the end of adjuvant oxaliplatin chemotherapy. (3) Results: Out of 406 patients, the prevalence of CIPN was 31.3% (95% confidence interval: 26.8-36.0). Little improvement in CIPN was found over the 5 years, and 36.5% of patients with CIPN also had neuropathic pain. CIPN was associated with anxiety, depression, and deterioration of quality of life. None of the patients with CIPN were treated with duloxetine (recommendation from American Society of Clinical Oncology), and only 3.2%, 1.6%, and 1.6% were treated with pregabalin, gabapentin, and amitriptyline, respectively. (4) Conclusions: Five years after the end of chemotherapy, a quarter of patients suffered from CIPN. The present study showed marked psychological distress and uncovered a failure in management in these patients.

Keywords: cancer survivors; colorectal cancer; health-related quality of life; oxaliplatin; peripheral neuropathy.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart of patient inclusion.
Figure 2
Figure 2
Prevalence of sensory CIPN and QLQ-CIPN20 sensory scores from 1 year until 5 years after chemotherapy end. The prevalence of sensory CIPN (A) is expressed as a percentage (white: no CIPN, black: sensory CIPN). The sensory scores (B) are expressed as mean ± standard deviation. p-values are provided for global comparison over time (from year 1 to year 5). CIPN, chemotherapy-induced peripheral neuropathy.
Figure 3
Figure 3
Severity proportions of the QLQ-CIPN20 items assessing tingling, numbness, and pain in the hands and feet among patients with sensory CIPN. The response categories were recoded to yield a dichotomous outcome per item (white: “not at all” or “a little” vs. black: “quite a bit” or “very much”). Results are expressed by percentage.
Figure 4
Figure 4
Forrest plot of the regression coefficients comparing QLQ-CIPN20 sensory scores with patient characteristics and oxaliplatin treatments. Multivariable analyses were performed, including patient characteristics (sex, age, tobacco, alcohol, and variation of weight) and characteristics of chemotherapy (chemotherapy date, cumulative dose and dose intensity of oxaliplatin, and center). * p < 0.05, ** p < 0.01, and *** p < 0.001.
Figure 5
Figure 5
Proportion of patients with anxiety or depression (Hospital Anxiety and Depression scale) according to sensory CIPN. Results are expressed as percentages.
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