Risk factors of paclitaxel-induced peripheral neuropathy in patients with breast cancer: a prospective cohort study

Sun Lixian; Yu Xiaoqian; Guo Luyan; Zhou Lizhi; Du Rui; Yao Hongyue; Zhao Caijie; Yuan Fenghui

doi:10.3389/fonc.2024.1327318

Risk factors of paclitaxel-induced peripheral neuropathy in patients with breast cancer: a prospective cohort study

Front Oncol. 2024 Mar 7:14:1327318. doi: 10.3389/fonc.2024.1327318. eCollection 2024.

Authors

Sun Lixian¹, Yu Xiaoqian¹, Guo Luyan¹, Zhou Lizhi², Du Rui², Yao Hongyue², Zhao Caijie³, Yuan Fenghui⁴

Affiliations

¹ School of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, China.
² Breast Surgery, Tangshan People's Hospital, Tangshan, China.
³ School of Nursing, Tangshan Vocational and Technical College, Tangshan, China.
⁴ Department of Neurology, Kailuan General Hospital, Tangshan, China.

Abstract

Objective: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and severe adverse reaction in taxane-based chemotherapy. This study aimed to analyze the risk factors of peripheral neuropathy in patients with breast cancer receiving paclitaxel chemotherapy to provide a reference for the early prevention of CIPN.

Methods: We included 350 patients with breast cancer who received chemotherapy for the first time at the Tangshan People's Hospital between August 2022 and June 2023 and were followed for at least 3 months after the end of chemotherapy. The incidence of CIPN in patients with breast cancer was calculated, and risk factors for CIPN were analyzed using logistic regression analysis.

Results: The incidence rate of CIPN was 79.1%. Multifactor logistic regression analysis indicated that age ≥45 years [odds ratio (OR)=5.119, 95% confidence interval (CI)=1.395-18.780] and ≥60 years (OR=9.366, 95% CI=1.228-71.421), history of hypertension (OR=3.475, 95% CI=1.073-11.250), cumulative dose of chemotherapy drugs >900 mg (OR=4.842, 95% CI=1.961-5.946), vitamin D deficiency (OR=6.214, 95% CI=2.308-16.729), abnormal alanine aminotransferase (OR=3.154, 95% CI=1.010-9.844), anemia before chemotherapy (OR=2.770, 95% CI=1.093-7.019), infusion duration of chemotherapy drugs >30 min (OR=3.673, 95% CI=1.414-9.539), body mass index ≥24 kg/m² (OR=8.139, 95% CI=1.157-57.240), mild depression (OR=4.546, 95% CI=1.358-15.223), and major depression (OR=4.455, 95% CI=1.237-16.037) increased the risk of CIPN. Having a regular caregiver (OR=0.223, 95% CI=0.087-0.573), high levels of physical activity (OR=0.071, 95% CI=0.008-0.647), and strong social support (OR=0.048, 95% CI=0.003-0.682) were protective factors against CIPN.

Conclusion: Clinical attention should be paid to patients with these risk factors, and active and effective preventive measures should be taken to reduce the occurrence of CIPN and improve the quality of life.

Keywords: breast cancer; chemotherapy; paclitaxel; peripheral neuropathy; risk factor.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Key Research and Development Program of Hebei Province (No.21377748D); Medical Science Research Project of Hebei Province (No. 20231807); Talent Support Project of Tangshan City (No.A202301005).