Self-Reported Severity, Characteristics, and Functional Limitations of Chemotherapy-Induced Peripheral Neuropathy

Background: The early identification of chemotherapy-induced peripheral neuropathy (CIPN) (e.g., numb-ness or tingling in the fingers or toes) is important due to its frequency and the few effective treatment options available. The identification of common patient-reported CIPN characteristics and associated functional limitations may help to facilitate patient-clinician discussions of CIPN in practice. Aims: To quantify the severity, duration, location, characteristics, and associated functional limitations of chemotherapy-induced peripheral neuropathy (CIPN) in patients receiving neurotoxic chemotherapy. Design: Exploratory secondary analysis of a prospective, two-phase study Setting: Breast, gastrointestinal, and multiple myeloma clinics at Dana-Farber Cancer Institute.Participants: 142 individuals who planned to receive at least three more cycles of neurotoxic chemotherapy after consent. Methods: Participants self-reported CIPN using standardized measures (i.e., PRO-CTCAETM Numbness and Tingling Items or 0-10 numerical rating scale of worst CIPN pain intensity) and/or study team generated follow up questions about CIPN location, duration, characteristics, and functional limitations prior to three consecutive clinic visits (T1, T2, T3). Participants' responses to the CIPN self-report questionnaires were described by chemotherapy type and age. Results: Over approximately 36.5 days (T1-T3), the percentage of participants reporting at least mild CIPN increased from 59.3% to 71%. At T3, patients with non-painful (n = 98) or painful neuropathy (n = 34) frequently reported symptoms in the fingers (non-painful = 83.5%, painful = 76.5%) or toes (non-painful = 49.5%, painful = 41.2%) and characterized symptoms as numbness (non-painful = 54.1%, painful = 50%) or tingling (non-painful = 68.4%, painful = 82.4%). Self-reported CIPN functional limitations (n = 55) included difficulties with buttoning a shirt (38.2%) or walking (25.5%). Paclitaxel-related CIPN (n = 33) was frequently characterized as "continuous " (30.3%), whereas oxaliplatin-related CIPN (n = 51) was frequently characterized as "intermittent " (41.2%). Young adults (15-39 years old, n = 15) frequently reported moderate-severe non-painful CIPN (46.7%), painful CIPN (40%), and CIPN interference (33.3%). Conclusions: Consistent with qualitative research, participants frequently described CIPN as numbness and/or tingling in the fingers and/or toes.(c) 2021 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.