Sensory Neuropathy Common After Adjuvant Chemotherapy
Chronic pain following adjuvant chemotherapy with docetaxel or oxaliplatin may be solely account for by pure sensory neuropathy.
According to a recent study published in Pain Medicine, chronic pain in some patients following adjuvant chemotherapy with docetaxel or oxaliplatin may be the result of pure sensory neuropathy, with similar pain characteristics and patterns for the 2 treatments. The chemotherapy-associated chronic pain and neuropathy were shown to have a substantial impact on patients' lives.
Researchers recruited patients with chronic pain or neuropathy following adjuvant oxaliplatin treatment for colorectal cancer (n=20) or adjuvant docetaxel for breast cancer (n=18). Quality of life, anxiety, depression, pain, and neuropathy were evaluated using questionnaires. Pain and neuropathy patterns were further characterized with quantitative sensory testing and nerve conduction studies.
Compared with patients receiving oxaliplatin, those who received docetaxel had increased mean depression scores (P =.04), increased mean anxiety scores (P =.02), and higher mean pain catastrophizing scores (P =.01).
Overall, patients were more likely to report dysesthesia than pain. Patients in both groups commonly characterized their pain as pricking, numbness, or burning. Paradoxic heat sensation was similar in the 2 groups (13 in oxaliplatin and 8 in docetaxel; P =.33). With the exception of vibration detection threshold, the remainder of the quantitative sensory testing values for cold detection threshold, warm detection threshold, and pressure pain threshold were within normal range.
Nerve conduction studies revealed that 11 patients from the oxaliplatin group and 4 from the docetaxel group had pure sensory neuropathy. Most patients in the oxaliplatin group (80%) had a large fiber polyneuropathy compared with 28% of patients in the docetaxel group.
The study investigators concluded that “both oxaliplatin-induced and docetaxel-induced polyneuropathies represent a significant problem that affects the daily life of patients.... Patients in both groups mainly had a sensory, axonal large, or mixed fiber polyneuropathy, which tended to be most severe in the oxaliplatin group.”
Ventzel L, Madsen CS, Karlsson P, et al. Chronic pain and neuropathy following adjuvant chemotherapy [published online September 23, 2017]. Pain Medicine. doi: 10.1093/pm/pnx231