The trend of chemotherapy-induced peripheral neurotoxicity in ovarian cancer survivors and its impacts on daily life during and one year after treatment.

ABSTRACT

PURPOSE: To explore the trend of progression and regression of peripheral neuropathy (PN) induced by combination of carboplatin and paclitaxel, and the impacts on daily activities. MATERIALS AND METHODS: PN was evaluated by nurse-based interview and patient-reported measures in their diary. The severity of PN scaled by National Cancer Institute Common Toxicity Criteria (NCI-CTC) before each cycle of chemotherapy and at three, six, and 12 months after drug withdrawal and coded as Grade I - V. RESULTS: The authors enrolled 106 eligible patients with ovarian cancer who underwent six cycles of combined chemotherapy of carboplatin plus paclitaxel. No patients showed Grade IV and V of PN and it was gradually aggravated following the dose accumulation. About 29.3% of the patients presented no PN, 64.2% Grade I, and 6.6% Grade II after the third course of chemotherapy, but increased to 36.8% of Grade I, 25.5% of Grade II, and 34.9% of Grade III after the sixth course of chemotherapy. At one-year follow-up, the rate of PN still existed with the rate of 88.5%, 57.3%, and 38.7% at three, six, and 12 months after drug withdrawal. Thirty-one patients encountered accidents, such as sharp injury (14.2%), fall (9.4%), burn (3.8%), and cold injury (1.9%). CONCLUSIONS: A significant proportion of patients with epithelial ovarian cancer treated with carboplatin plus paclitaxel suffer long term neuropathy and it affects patient's daily activities. Specialized care is necessary to provide not only during treatment, but also months to years after drugs withdrawal.