ABSTRACT:
BACKGROUND:
Breast cancer is the most common malignancy in women in the United States and is second only to lung cancer as a cause of cancer death. Worldwide, breast cancer is the most frequently diagnosed cancer and the chief cause of cancer death among females.
The National Comprehensive Cancer Network Guidelines recommend taxanes for the treatment of early-stage and metastatic breast cancer. Peripheral neuropathy is a common non-hematological side effect of taxanes, which may result in chemotherapy delays, reductions, discontinuations and poor quality of life. Taxane-induce peripheral nerve damage can lead motor and sensory symptoms. Initial detection of peripheral neuropathy simplifies complete regression since an acute taxane induce peripheral neuropathy is both reversible and mild to moderate in severity.
Till now, there are no accepted preventive procedures or expectable parameters for chemotherapy induced peripheral neuropathy including taxanes, however duloxetine 60mg was official in large randomized phase 3 trials for treatment of chemotherapy induce peripheral neuropathy.
PATIENTS AND METHOD:
Single institution retrospective study started between November 2019 to December 2020, was conducted in Babil Oncology Center/Babil/Iraq which included 60 randomly selected patients with breast cancer, receiving chemotherapy including Taxane group and had undergone nerve conduction study. A collected multiple demographic parameters were compared by dividing the patients into two groups; patients who developed taxane induce peripheral neuropathy and patients who were not developed, these parameters were: patient age, body mass index , hormonal receptor status, human epidermal growth receptor 2 status, metastatic setting and duration and period of last cycle of taxane received. The clinical information, histological and immunohistochemistry laboratory results for each patient obtained from the Oncology Patients Archive Unit, then the statistical process was carried out on the collected information.
RESULTS:
Of 60 patients included in this study, 15 patients (25 %) developed taxane related peripheral neuropathy, of whom 13 (86.7%) developed mixed sensorimotor peripheral neuropathy and two (13.3%) patients developed sensory neuropathy. While the severity ranged from mild (one patient), mild to moderate (10 patients), moderate (4 patients) and there was neither sever nor life threatening peripheral neuropathy. The mean age of patients was 51.38 years and mean body mass index of patients was 26.24 Kg/m2. Peripheral neuropathy had statically significant association with age, body mass index and human epidermal growth receptor 2. Peripheral neuropathy was somewhat more in metastatic setting but statically insignificant.
CONCLUSION:
About one fourth of patients developed peripheral neuropathy after receiving taxane chemotherapy. Elderly, obese patients and patients who have human epidermal growth receptor 2 positive tumors are predictors for taxane induce peripheral neuropathy.
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