Changes in Chemotherapy-induced Peripheral Neuropathy, Sleep Quality, and Quality of Life following Chemotherapy in Stomach Cancer Patients: a Prospective Study

Purpose: The purpose of this study was to identify the changes of chemotherapy induced peripheral neuropathy (CIPN), sleep quality, and quality of life and their interrelationships following chemotherapy. Methods: A sample of 52 patients who had been diagnosed with stomach cancer receiving oxaliplatin containing chemotherapy were included in a prospective longitudinal study. The assessment tools were Chemotherapy-induced Peripheral Neuropathy 20, Pittsburgh Sleep Quality Index, and EORTC Quality of Life-Cancer. The data were collected at three time points: pre-chemotherapy, post-chemotherapy, and three months after the completion of chemotherapy, using questionnaires given between June 2017 and March 2019. Data were analyzed using descriptive statistics, repeated measures analysis of variance, and multiple regression analysis. Results: Post-chemotherapy, 19.2% of patients complained of CIPN and 21.2% exhibited CIPN at three-month follow-up. Repeated measures ANOVA showed a significant increase in CIPN after chemotherapy and it remained high at three-month follow-up (F = 39.90, p<.001). Functional quality of life (F = 8.23, p<.001) and symptom quality of life (F = 7.88, p=.001) also showed significant decreases after chemotherapy, and symptom quality of life remained low at three-month follow-up. However, for sleep quality, no significant main effect of time point was shown. CIPN and sleep quality were a factor influencing quality of life with an explanatory power of 48.3% at post-chemotherapy and 65.3% at three-month follow up. Conclusion: These results suggest that chemotherapy is highly associated with CIPN and symptoms affecting quality of life in cancer patients. Nursing intervention is needed to monitor and relieve these symptoms of patients during the cancer care trajectory.