Incidence and Risk Factors Associated with Platinum Derivative Chemotherapy-Induced Peripheral Neuropathy during Antineoplastic Treatment.

BACKGROUND: This study retrospectively analyzed the incidence and risk factors associated with platinum-induced sensory peripheral neuropathy (PSPN).

METHODS: Before each chemotherapy cycle, patients were routinely evaluated for the presence and severity of PSPN based on the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale, which ranges from 0 to 4. Information from two years of evaluations was collected, and patient medical records were reviewed to obtain data on chemotherapy cycle, sex, age, body mass index, body surface area, primary tumor, chemotherapy protocol, history of head and neck radiotherapy, and overall survival. The X2 test, multinomial logistic regression, and Kaplan-Meier curves were used for statistical analysis (SPSS 20.0, p < 0.05).

RESULTS: Among 3,140 patients, 16,878 events were evaluated, with 7,187 (42.58%), 5,514 (32.67%), and 4,177 (24.75%) patients treated with cisplatin, carboplatin, or oxaliplatin, respectively. The incidence of any event of PSPN was 98.85% and 1867 (11.16%) showed scores two or higher (PSNP interfering with activities of daily living (ADL). Carboplatin and oxaliplatin (p<0.001), ≥5 CT cycles (p<0.001), body mass index >25 (p=0.005), advanced T (p<0.001), N (p=0.025) and M (p=0.010) clinical stages as well as  association with capecitabine (p=0.021), paclitaxel (p=0.027) or vinorelbine (p=0.031) significantly increased risk of PSNP interfering in ADL. Over 48 months of evaluation, overall survival was 87.3% (n = 2741/3140), and PSNP interfering with ADLs significantly increased the risk of death by 1.52-fold (95% CI = 1.19-1.95, p = 0.001).

CONCLUSION: PCPN has a high incidence, and significant risk factors include BMI, age, number of CT cycles, advanced stages, and associations with capecitabine, paclitaxel, and vinorelbine, all of which are associated with lower overall survival.