Chemotherapy-induced peripheral neuropathy

This review explored recent evidence regarding chemotherapy-induced peripheral neuropathy following treatment with different types of chemotherapeutic agents.

Chemotherapy, often used in the treatment of cancer, is well-known for its short-term toxic side-effects such as nausea or hair loss. However, symptoms of peripheral neuropathy (peripheral nerve damage), including numbness, tingling, hot or cold sensation and pain, may persist long after the end of treatment. This review assessed the incidence and risk of peripheral neuropathy according to different types of chemotherapy agents used.

Among the most commonly used chemotherapeutic agents in the treatment of breast cancer, taxanes, such as paclitaxel and docetaxel were determined the most likely to cause peripheral neuropathy. These agents are known to cause numbness and tingling, and in some cases may cause muscle pain and affect fine motor skills or walking. Evidence suggests that the risk of taxane-induced neuropathy is significantly increased by infusion of large single doses and by increased cumulative doses (referred to as dose-dependent; escalating with increased exposure). For example, one trial reviewed determined that up to 75% of patients receiving large paclitaxel infusion doses (175 mg/m² or greater) experience peripheral neuropathy, with symptoms typically appearing at a cumulative dose of 300mg/m². A second trial found a lower incidence of neuropathy when paclitaxel was administered once weekly compared to twice weekly. In comparison, evidence suggests that longer infusion durations may reduce neuropathy among patients receiving taxanes. Neuropathy symptoms such as numbness and muscle weakness were found to persist for more than 3-years following treatment in up to 41% of patients.

This review concluded that chemotherapy-induced peripheral neuropathy significantly affects quality of life, even among long-term survivors. Identifying ways to prevent peripheral neuropathy and developing treatments should be the focus of future research.