The course of peripheral neuropathy and its association with health-related quality of life among colorectal cancer patients

Abstract

Purpose: To gain more insight into the course of chemotherapy-induced peripheral neuropathy (CIPN) and its impact on health-related quality of life (HRQoL) in a population-based sample of colorectal cancer (CRC) patients up to 2 years after diagnosis.

Methods: All newly diagnosed CRC patients from four hospitals in the Netherlands were eligible for participation in an ongoing prospective cohort study. Patients (n = 340) completed questions on CIPN (EORTC QLQ-CIPN20) and HRQoL (EORTC QLQ-C30) before initial treatment (baseline) and 1 and 2 years after diagnosis.

Results: Among chemotherapy-treated patients (n = 105), a high sensory peripheral neuropathy (SPN) level was reported by 57% of patients at 1 year, and 47% at 2-year follow-up, whereas a high motor peripheral neuropathy (MPN) level was reported by 47% and 28%, at years 1 and 2, respectively. Linear mixed model analyses showed that SPN and MPN symptoms significantly increased from baseline to 1-year follow-up and did not return to baseline level after 2 years. Patients with a high SPN or MPN level reported a worse global quality of life and a worse physical, role, emotional, cognitive, and social functioning compared with those with a low SPN or MPN level.

Conclusions: Future studies should focus on understanding the mechanisms underlying CIPN so targeted interventions can be developed to reduce the impact of CIPN on patient's lives.

Implications for cancer survivors: Patients need to be informed of both CIPN and the impact on HRQoL.

Keywords: Colorectal cancer; Health-related quality of life; PROFILES; Peripheral neuropathy.

Fig. 1

Flowchart of the study. *Characteristics of eligible CRC patients were obtained from the Netherlands Cancer Registry. ^†Among chemotherapy-treated CRC patients only, 76% completed 1-year follow-up and 79% completed 2-year follow-up

Fig. 2

Course of sensory, motor, and autonomic peripheral neuropathy among colorectal cancer patients, stratified by chemotherapy. A higher score on the scales indicates more neuropathy symptoms. The scale in this figure ranges from 0 to 50 for clear visibility of the course of the peripheral neuropathy symptoms, while total scores of the EORTC QLQ-CIPN20 range from 0 to 100

Fig. 3

Course of health-related quality of life for colorectal cancer patients according to them ever or never reporting high sensory peripheral neuropathy (a) or motor peripheral neuropathy (b). *Significant difference between patients who “ever” reported high SPN/MPN and those who “never” reported high SPN/MPN, but of no clinical relevance. ^‡Significant difference, of small clinical relevance. ^†Significant difference, of medium clinical relevance. ^¥Significant difference, of large clinical relevance. The scale in this figure ranges from 50 to 100 for clear visibility of the association between peripheral neuropathy and health-related quality of life, while total scores of the EORTC QLQ-C30 range from 0 to 100