Unraveling the Burden of Chemotherapy-Induced Peripheral Neuropathy: A Prospective Clinical Insight from 50 Cancer Patients
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Abstract
Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, dose-limiting toxicity of neurotoxic chemotherapy that significantly impairs quality of life (QoL) and functional status. Despite its clinical relevance, data on real-world incidence, severity, and early recovery patterns remain limited. Objective: To prospectively evaluate the clinical spectrum, risk factors, treatment impact, and short-term reversibility of CIPN in cancer patients receiving neurotoxic chemotherapy. Methods: This 18-month prospective observational study enrolled 50 adult cancer patients undergoing treatment with known neurotoxic agents, including paclitaxel, oxaliplatin, docetaxel, cisplatin/carboplatin, and bortezomib. CIPN was assessed using NCI-CTCAE v5.0, and functional impact was measured via FACT/GOG-Ntx. Patients were evaluated at baseline, during chemotherapy, at treatment completion, and three months post-therapy. Associations between severe CIPN (Grade ≥2) and risk factors such as cumulative dose, age, and diabetes were analyzed. Results: The cohort had a mean age of 54.3 years (range 28–72), with 60% female. Sensory neuropathy occurred in all patients (100%), most commonly presenting as tingling (80%), numbness (72%), and burning pain (44%). CIPN severity was Grade 1 in 44%, Grade 2 in 30%, Grade 3 in 20%, and Grade 4 in 6% of patients. Severe neuropathy was significantly associated with cumulative paclitaxel dose >600 mg/m², oxaliplatin >780 mg/m², and presence of diabetes (p<0.05). CIPN led to treatment modifications in 38% of patients, including dose reductions, delays, or permanent discontinuation. Quality-of-life scores declined by a mean of 19 points (p<0.01). At three months post-treatment, 30% of patients had complete resolution, 50% showed partial improvement, and 20% had persistent neuropathy. Conclusion: CIPN is highly prevalent, predominantly sensory, and significantly impacts QoL and treatment continuity. Higher cumulative doses and diabetes increase the risk of severe neuropathy. Although most patients demonstrated partial recovery by three months, persistent symptoms in 20% highlight the potential for chronic CIPN. Early detection, risk-based monitoring, and timely dose adjustments are essential to mitigate neurotoxicity and optimize patient outcomes.
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Copyright (c) 2025 Dr Zahoor Ahmad Paul, Dr Tavseef Ahmad Tali, Dr Mustafa Bashir, Dr Peerzada Ajaz Ahmad Shah, Dr Toufeeq Ahmed Teli
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
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