Relationship between Chemotherapy-induced Peripheral Neuropathy and Quality of Life in Patients with Hematologic Malignancies

Chi Eun Song; Hye Young Kim; Eun Sook Lee

doi:10.7469/kjan.2015.27.3.358

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Song, Kim, and Lee: Relationship between Chemotherapy-induced Peripheral Neuropathy and Quality of Life in Patients with Hematologic Malignancies

Original Article

Korean J Adult Nurs 2015;27(3):358-366.

Published online: NaN June 2015

DOI: https://doi.org/10.7469/kjan.2015.27.3.358

Relationship between Chemotherapy-induced Peripheral Neuropathy and Quality of Life in Patients with Hematologic Malignancies

Chi Eun Song¹, Hye Young Kim², Eun Sook Lee³

^¹Department of Hematology, Chonnam National University Hwasun Hospital, Hwasun

^²College of Nursing, Chonbuk National University, Jeonju

^³Department of Nursing, Gyeongnam National University of Science and Technology, Jinju, Korea

Corresponding author: Kim, Hye Young College of Nursing, Chonbuk National University, 20 GunJi-ro, Deokjin-gu, Jeonju 561-712, Korea. Tel: +82-63-270-4618, Fax: +82-63-270-3127, E-mail: tcellkim@chonbuk.ac.kr

Received 26 January 201519 May 2015 Accepted 24 May 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was aimed to identify the incidence and severity of chemotherapy-induced peripheral neuropathy (CIPN) among patients with hematologic malignancies and to examine the relationship between the quality of life (QOL) and CIPN.

Methods

A total of 66 patients with CIPN-related symptoms participated in this study. Data were collected through self-reported questionnaires consisted of the European Organization for Research and Treatment of Cancer QLQ-C30 version 3.0 and the 16-item QLQ-CIPN20. Data were analyzed with SPSS/ WIN20 for descriptive statistics using the Mann-Whitney and Kruskal-Wallis tests, and Spearman's rho.

Results

The mean lower and upper extremity scale scores were 31.95 and 23.16 respectively for the 16-item QLQ-CIPN20. The mean QLQ-C30 subcategory scores were 46.84 for global health status, 58.72 for functional scales, and 34.85 for symptom scales. The CIPN-related lower extremity scale symptoms correlated negatively with the QOL subscales. There was no correlation between CIPN-related upper extremity symptoms and health-related QOL.

Conclusion

Patients with hematologic malignancies treated with neurotoxic chemotherapeutic agents had CIPN-related symptoms in the lower extremities mainly, and their QOL functional subscale scores were relatively lower than those of other cancer patients. Interventions need to be developed for patients with hematologic malignancies to alleviate CIPN and enhance their QOL.

Keywords: Quality of life, Chemotherapy, Peripheral neuropathies, Hematologic malignancy

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Figure 1.

Percentage of patients who reported "quite a bit" or "very much"tingling, numbness, and/or shooting/burning pain on the 16-item QLQ-CIPN20 sensory scales.

Table 1.

Mean Rank Differences in CIPN and QOL, according to the General and Clinical Characteristics (N=66)

Characteristics	Categories	n (%)	CIPN				QOL
			Lower extremity scales		Upper extremity scales		Global health status scales		Functional scales		Symptom scales
			Mean rank	p	Mean rank	p	Mean rank	p	Mean rank	p	Mean rank	p
Gender	Male	43 (65.2)	34.94	.403	34.37	.612	34.53	.544	31.88	.349	34.44	.585
Gender	Female	23 (34.8)	30.80		31.87		31.57		36.52		31.74
Age (year)	≤49	15 (22.7)	19.67	.004	30.07	.759	44.33	.038	47.20	.014	21.87	.060
	50–59	20 (30.3)	35.55		36.78		34.98		31.60		38.60
	60–69	15 (22.7)	33.03		34.07		28.27		30.10		35.30
	≥70	16 (24.2)	44.34		32.09		26.41		26.22		36.34
Education	≤Middle school	24 (36.3)	41.69	.009	30.19	.287	27.71	.060	25.92	.015	38.81	.089
Education	≥High school	42 (63.7)	28.82		35.39		36.81		37.83		30.46
Employment	Yes	22 (33.3)	32.16	.688	31.41	.529	32.07	.664	33.64	.967	30.64	.391
Employment	No	44 (66.7)	34.17		34.55		34.22		33.43		34.93
ECOG PS	≤1	55 (83.3)	31.05	.020	33.05	.665	36.25	.008	35.99	.018	31.92	.134
ECOG PS	≥2	11 (16.7)	45.73		35.77		19.73		21.05		41.41
Diagnosis	ALL	7 (10.6)	24.86	＜.001	38.21	.778	25.86	.309	30.50	.097	35.79	.303
	NHL	28 (42.4)	24.21		33.36		37.09		39.41		29.27
	MM	31 (47.0)	43.84		32.56		31.98		28.84		36.81
Duration of diagnosis (months)	≤4	18 (27.3)	24.36	.025	33.58	.837	29.11	.063	33.86	.027	35.86	.093
	5–12	18 (27.3)	30.33		30.83		43.75		43.53		23.83
	13–24	9 (13.6)	37.94		32.11		29.06		32.83		37.39
	≥25	21 (31.8)	42.14		36.31		30.38		24.88		38.10
Current chemotherapy	Yes	46 (69.7)	33.72	.889	34.29	.609	32.71	.606	31.17	.135	37.80	.006
Current chemotherapy	No	20 (30.3)	33.00		31.68		35.33		38.85		23.60
Duration of CIPN (month)	≤4	26 (39.4)	21.02	＜.001	33.87	.833	32.15	.173	36.42	.008	31.83	.071
	5–12	17 (25.8)	36.72		29.25		41.16		41.63		25.34
	13–24	6 (9.0)	38.00		35.00		32.42		31.17		31.67
	≥25	17 (25.8)	46.06		34.50		26.82		20.29		42.47
Exposure to neurotoxic agents	Single	45 (68.2)	26.83	＜.001	32.83	.678	35.16	.298	37.42	.015	30.02	.031
	Multiple	21 (31.8)	47.79		34.93		29.95		25.10		40.95

CIPN=chemotherapy-induced peripheral neuropathy; QOL=quality of life; ECOG PS=Eastern Cooperative Oncology Group performance status; ALL=Acute lymphocytic leukemia; NHL=non-Hodgkin lymphoma; MM=multiple myeloma.

Table 2.

Scores from the 16-item QLQ-CIPN20 Subscales and EORTC QLQ-C30 Subscales (N=66)

Variables		M±SD
16-item QLQ-CIPN20	Lower extremity scales	31.95±23.30
16-item QLQ-CIPN20	Upper extremity scales	23.16±19.01
EORTC QLQ-C30	Global health status scales	46.84±21.62
	Functional scales	58.72±20.61
	Physical scales	56.24±21.71
	Role scales	51.01±36.97
	Emotional scales	71.46±25.61
	Cognitive scales	62.12±28.58
	Social scales	41.16±36.19
	Symptom scales	34.85±16.79
	Fatigue	55.22±27.90
	Nausea & vomiting	11.11±16.10
	Pain	30.56±30.74
	Dyspnea	41.41±35.60
	Insomnia	37.88±38.73
	Appetite loss	37.88±36.46
	Constipation	22.22±36.20
	Diarrhea	12.12±21.59
	Financial problem	52.53±40.95

16-item QLQ-CIPN20=16-item quality of life questionnaire-chemotherapy-induced peripheral neuropathy; EORTC QLQ-C30= European Organization for the Research and Treatment of Cancer quality of life questionnaire core 30 items.

Table 3.

Correlation between Health-related QOL and Peripheral Neuropathy Status (N=66)

Subscales in EORTC QLQ-C30	Subscales in 16-item QLQ-CIPN
	Lower extremity	Upper extremity
	rho (p)	rho (p)
Global health status	-.243 (.050)	-.075 (.550)
Functional	-.469 (.002)	-.236 (.057)
Symptom	.463 (.002)	.126 (.314)

QOL=quality of life; 16-item; QLQ-CIPN20=16-item quality of life questionnaire-chemotherapy-induced peripheral neuropathy; EORTC QLQ-C30=European Organization for the Research and Treatment of Cancer quality of life questionnaire core 30 items.

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