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. 2019 Oct;27(10):3905-3912.
doi: 10.1007/s00520-019-04695-3. Epub 2019 Feb 15.

Age-related differences in patient-reported and objective measures of chemotherapy-induced peripheral neuropathy among cancer survivors

Melisa L Wong  1 , Bruce A Cooper  2 , Steven M Paul  2 , Gary Abrams  3 , Kimberly Topp  4 , Kord M Kober  5 , Margaret A Chesney  6 , Melissa Mazor  5 , Mark A Schumacher  7 , Yvette P Conley  8 , Jon D Levine  9 , Christine Miaskowski  5
Affiliations

Age-related differences in patient-reported and objective measures of chemotherapy-induced peripheral neuropathy among cancer survivors

Melisa L Wong et al. Support Care Cancer. 2019 Oct.

Abstract

Purpose: While older adults with cancer are more likely to develop chemotherapy-induced peripheral neuropathy (CIPN), the study aimed to determine if patient-reported and objective measures of CIPN differ by age among cancer survivors.

Methods: Cancer survivors with persistent CIPN after completion of platinum and/or taxane chemotherapy completed CIPN questionnaires (severity, interference with activities, sensory, and motor symptoms) and objective testing (light touch, vibration, pain, cold sensation). CIPN measures were compared by age group (< 65 n = 260 versus ≥ 65 n = 165) using parametric and nonparametric tests.

Results: Among 425 cancer survivors with CIPN, mean age was 60.9 (SD 10.5). CIPN location did not differ by age (overall 68% hands and feet, 27% only feet, 5% only hands). For patient-reported measures, older survivors reported less severe pain in the hands and feet than younger survivors. In addition, older survivors reported lower interference with general activity, routine activities, normal work, enjoyment of life, sleep, mood, relations with other people, and sexual activity. No age differences in sensory and motor symptom scores were found. In contrast, for objective measures, older survivors had worse light touch and cold sensations in their feet and worse vibration detection in their hands and feet.

Conclusions: Despite having worse light touch, cold, and vibration sensations, older cancer survivors with CIPN reported less severe pain and interference with activities. This discordance highlights the importance of including both patient-reported and objective measures to assess CIPN in cancer survivors to better evaluate this clinical condition.

Keywords: Age; Cancer survivor; Chemotherapy; Chemotherapy-induced peripheral neuropathy; Patient-reported outcomes.

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Conflict of interest statement

CONFLICT OF INTEREST

Dr. Wong has reported a conflict of interest outside of the submitted work (immediate family member is an employee of Genentech with stock ownership). The remaining authors have no conflicts to report.

Figures

Figure 1.
Figure 1.
Mean pain interference scores with 95% confidence intervals for chemotherapy-induced peripheral neuropathy in the (A) upper and (B) lower extremities according to age group. *P<0.05 **P<0.01 †Routine activities such as dressing, toileting, and typing. ‡Normal work includes both work outside the home and housework.
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