Factors Influencing Peripheral Neuropathy of Cancer Patients Undergoing Chemotherapy

Yeon Ji Yoon; Jeong Sook Park

doi:10.5388/aon.2019.19.2.71

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Yoon and Park: Factors Influencing Peripheral Neuropathy of Cancer Patients Undergoing Chemotherapy

Original Article

Asian Oncol Nurs 2019;19(2):71-80.

Published online: 5 June 2019

DOI: https://doi.org/10.5388/aon.2019.19.2.71

Factors Influencing Peripheral Neuropathy of Cancer Patients Undergoing Chemotherapy

Yeon Ji Yoon¹, Jeong Sook Park²

¹Keimyung University Dongsan Medical Center, Daegu, Korea

²College of Nursing, Keimyung University, Daegu, Korea

^∗ This article is based on part of the first author's master's thesis from Keimyung University.

Address reprint requests to: Park, Jeong Sook College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea Tel: +82-53-580-3907 Fax: +82-53-580-3916 E-mail: jsp544@kmu.ac.kr

Received 13 Feb 201930 Mar 2019 Accepted 9 Apr 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License (http://creativecommons.org/licenses/by-nd/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Purpose

We conducted a descriptive study to identify the factors affecting peripheral neuropathy in cancer patients undergoing chemotherapy.

Methods

Data were collected from 131 cancer patients who underwent chemotherapy at two university hospitals in D city from January to July in 2018. The instruments used were the European Organization for Research and Treatment of Cancer-Chemotherapy Induced Peripheral Neuropathy 20 (EORTC-QLQ CIPN 20), International Physical Activity Questionnaire (IPAQ), nutrition and eating habits, and Hospital Anxiety & Depression Scale (HADS).

Results

Factors influencing peripheral neuropathy in cancer patients undergoing chemotherapy were gender (β=-0.34, p=.005), basal cold hypersensitivity in the hands and feet (β=0.29, p<.001), depression (β=0.27, p=.002), and diabetes (β=0.23, p<.001). The explanatory power of the model was 41.1%.

Conclusion

Based on the results of the study, it is necessary to plan nursing interventions for cancer patients undergoing chemotherapy with peripheral neuropathy by considering gender, cold hypersensitivity in the hands and feet, depression, and diabetes.

Keywords: Chemotherapy, Peripheral neuropathy, Cancer

REFERENCES

1. National Cancer Information Center(KR). Statistics of cancer [Internet]. Available from. http://www.cancer.go.kr/mbs/cancer/index.jsp. [Accessed October 9, 2018].

2. Lee SY, Ham YH, Ok ON, Kim EJ, Kwon IG, Hwang MS, et al. The effects of foot reflexology on peripheral neuropathy, symptom distress, anxiety and depression in cancer patients treated with oxaliplatin. Asian Oncol Nurs. 2012; 12(4):305–13.

3. Tofthagen CS, McMillan SC, Kip KE. Development and psychometric evaluation of the chemotherapy-induced peripheral neuropathy assessment tool. Cancer Nurs. 2011; 34(4):E10–20.

4. Quasthoff S, Hartung HP. Chemotherapy-induced peripheral neuropathy. J Neurol. 2002; 249(1):9-17.

5. Miltenburg N, Boogerd W. Chemotherapy-induced neuropathy: a comprehensive survey. Cancer Treat Rev. 2014; 40(7):872–82.

6. Kwak MK, Kim EJ, Lee ER, Kwon IG, Hwang MS. Characteristics and quality of life in patients with chemotherapy-Induced peripheral neuropathy. Asian Oncol Nurs. 2010; 10(2):231–9.

7. Bao T, Basal C, Seluzicki C, Li SQ, Seidman AD, Mao JJ. Long-term chemotherapy-induced peripheral neuropathy among breast cancer survivors: prevalence, risk factors, and fall risk. Breast Cancer Res Treat. 2016; 159(2):327–33.

8. Boehmke MM, Dickerson SS. Symptom, symptom experiences, and symptom distress encountered by women with breast cancer undergoing current treatment modalities. Cancer Nurs. 2005; 28(5):382–9.

9. Grisold W, Cavaletti G, Windebank AJ. Peripheral neuropathies from chemotherapeutics and targeted agents: diagnosis, treatment, and pre-vention. Neuro Oncol. 2012; 14(4):45–54.

10. Vincenzi B, Frezza AM, Schiavon G, Spoto C, Addeo R, Catalano V, et al. Identification of clinical predictive factors of oxaliplatin-induced chronic peripheral neuropathy in colorectal cancer patients treated with adjuvant Folfox IV. Support Care Cancer. 2013; 21:1313–9.

11. Han JW. A study on type of chemotherapy-induced peripheral neuropathy symptom, influencing factors, and functional status. [master's thesis]. Seoul: Kyung Hee Univ.;2014.

12. Pereira S, Fontes F, Sonin T, Dias T, Fragoso M, Castro-Lopes J, et al. Chemotherapy-induced peripheral neuropathy after neoadjuvant or adjuvant treatment of breast cancer: a prospective cohort study. Support Care Cancer. 2016; 24(4):1571–81.

13. Reyes-Gibby CC, Morrow PK, Buzdar A, Shete S. Chemotherapy-induced peripheral neuropathy as a predictor of neuropathic pain in breast cancer patients previously treated with paclitaxel. J Pain. 2009; 10(11):1146–50.

14. Hershman DL, Weimer LH, Wang A, Kranwinkel G, Brafman L, Fuen-tes D, et al. Association between patient reported outcomes and quan-titative sensory tests for measuring long-term neurotoxicity in breast cancer survivors treated with adjuvant paclitaxel chemotherapy. Breast Cancer Res Treat. 2011; 125(3):767–74.

15. Greenlee H, Hershman DL, Shi Z, Kwan ML, Ergas IJ, Roh JM, et al. BMI, lifestyle factors and taxane-induced neuropathy in breast cancer patients: The pathways study. J Natl Cancer Inst. 2017; 109(2):1–8.

16. Derksen TM, Bours MJ, Mols F, Weijenberg MP. Lifestyle-related factors in the self-management of chemotherapy-induced peripheral neuropathy in colorectal cancer: a systemic review. Evid Based Complement Alternat Med. 2017; 1–14.

17. Han SS, Han SS, Han JW. The influences of depression, anxiety, social support and knowledge of anticancer drugs on the chemotherapy-induced peripheral neuropathy among colorectal cancer patients receiving oxaliplatin. Evid Based Complement Alternat Med. 2013; 19(2):298–308.

18. Jang JB, Lee KS, Song BK. Study on the definition of the female's part-coldness syndrome. J Korean Med. 1994; 15(2):397–411.

19. Park SO. Dietary and socioeconomic factors that influence on the in-take of B vitamins in pregnant women [master's thesis]. Seoul: Ewha Womans Univ.;2003.

20. Choi JI. A study on diet and nutritional status of breast cancer patient [master's thesis]. Seoul: Ewha Womans Univ.;2005.

21. Tofthagen C, Gonzlez L, Visovsky C, Akers A. Self-management of ox-aliplatin-related peripheral neuropathy in colorectal cancer survivors. Chemother Res Pract. 2013; 2013(1):1-7.

22. Oh JY, Yang YJ, Kim BS, Kang JH. Validity and reliability of Korean version of International Physical Activity Questionnaire (IPAQ) Short Form. J Korean Acad Fam Med. 2007; 28:532–41.

23. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67(6):361–70.

24. Oh SM, Min KJ, Park DB. A study on the standardization of the Hospital Anxiety Depression Scale for Koreans: a comparison of normal, de-pressed and anxious groups. J Korean Neuropsychiatr Assoc. 1999; 38(2):289–96.

25. Kim HM. Symptoms and relief therapy related to chemotherapy induced peripheral neuropathy in patients with cancer [master's thesis]. Daegu: Keimyung Univ.;2012.

26. Park YR. The relationships among the degree of peripheral neuropathy, a sense of control and the quality of life in cancer patients receiving chemotherapy [master's thesis]. Seoul: Dankook Univ.;2014.

27. Goveas JS, Espeland MA, Woods NF, Wassertheil-Smoller S, Kotchen JM. Depressive symptoms and incidence of mild cognitive impairment and probable dementia in elderly women: the women's health initiative memory study. J Am Geriatr Soc. 2011; 59(1):57–66.

28. Altaf R, Brixen AL, Kristensen B, Nielsen SE. Incidence of cold-induced peripheral neuropathy and dose modification of adjuvant oxaliplatin-based chemotherapy for patients with colorectal cancer. Oncology. 2014; 87(3):167–72.

29. Pop-Busui R, Boulton AJ, Feldman EL, Bril V, Freeman R, Malik RA, et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care. 2017; 40(1):136–54.

Table 1.

Characteristics of Peripheral Neuropathy of Cancer Patients undergoing Chemotherapy (N =131)

Variables	Categories	M ± SD
Sensory scale	Tingling fingers or hands	2.16 ± 0.91
	Tingling toes or feet	2.03 ± 0.97
	Numbness in your fingers or hands	1.69 ± 0.82
	Numbness in your toes or feet	1.62 ± 0.86
	Shooting or burning pain in fingers or hands	±1.43 ± 0.72
	Shooting or burning pain in toes or feet	1.44 ± 0.83
	Problems standing or walking because of difficulty feeling the ground under your feet	1.37 ± 0.73
	Difficulty distinguishing between hot and cold water	1.10 ± 0.33
	Difficulty hearing?	1.21 ± 0.46
	Subtotal	18.74 ± 17.89
Motor scale	Cramps in hands	1.29 ± 0.55
	Cramps in feet Problem holding a pen, which made writing difficult	1.27 ± 0.571.24 ± 0.57
	Difficulty manipulating small objects with fingers	1.24 ± 0.55
	Difficulty opening a jar or bottle because of weakness in hands	1.45 ± 0.76
	Difficulty walking because feet dropped downwards	1.27 ± 0.63
	Difficulty climbing stairs or getting up out of a chair because of weakness in legs	1.56 ± 0.76
	If you drive a car, difficulty using pedals?	1.08 ± 0.28
	Subtotal	10.56 ± 13.79
Autonomic scale	Feel dizzy when standing up from a sitting or lying position	1.82 ± 0.75
	Blurred vision	1.67 ± 0.78
	If you are a man, difficulty getting or maintaining an erection	1.86 ± 0.90
	Subtotal	25.65 ± 20.94
Total score		16.30 ± 14.51

Table 2.

Differences of Peripheral Neuropathy according to Characteristics of Cancer Patients undergoing Chemotherapy (N =131)

Variables	Categories	n (%) or M ± SD	M ± SD	t or F	p (Scheffé)
Age (year)	≤50	31 (23.7)	17.08 ± 15.83	0.06	.944
	51~70	83 (63.3)	16.08 ± 14.90
	≥71	17 (13.0)	15.97 ± 10.02
		57.15 ± 11.03
Gender	Male	41 (31.3)	11.47 ± 7.34	-2.63	＜.001
	Female	90 (68.7)	18.50 ± 16.36
Diagnosis	Colon cancer	58 (44.3)	14.56 ± 11.08	2.02	.115
	Gynecological cancer	30 (22.9)	14.65 ± 13.45
	Breast cancer	32 (24.4)	21.72 ± 20.18
	Others	11 (8.4)	14.23 ± 11.17
Types of anticancer drug	Oxaliplatin ^a Cisplatin^b	61 (46.6) 24 (18.3)	13.96 ± 10.7316.49 ± 11.94	3.63	.015 (a＜ c)
	Paclitaxel ^c	20 (15.3)	25.62 ± 23.73
	Docetaxel ^d	26 (19.8)	14.46 ± 13.14
Diabetes	Don't have Have	115 (87.8) 16 (12.2)	14.70 ± 12.0127.79 ± 28.83	-3.53	＜.001
Hypertension	Don't have	96 (73.3)	16.67 ± 13.95	0.49	.569
	Have	35 (26.7)	15.28 ± 16.11
Basal sensory abnormality	Don't have	83 (63.4)	11.84 ± 8.70	-5.05	＜.001
	Have	48 (36.6)	24.02 ± 18.82
Basal cold hypersensitivity in the hands and feet	Don't have Have	79 (60.3) 52 (39.7)	12.41 ± 9.4222.21 ± 18.49	-3.99	＜.001
		1.76 ± 2.68
Body Mass Index (kg/m²)	Normal (< 25.0)	86 (65.6)	15.46 ± 14.89	0.69	.501
	Overweight (25≤ BMI < 30.0)	42 (32.1)	17.48 ± 13.98
	Obesity (≥30.0)	3 (2.3)	23.91 ± 10.07
		23.60 ± 3.35
Hemoglobin	Abnormal (Female < 12 g/dL, Male <13 g/dL)	98 (74.8)	16.72 ± 13.63	0.57	.865
	Normal (Female≥12 g/dL, Male≥13 g/dL)	33 (25.2)	15.06 ± 17.22
		11.36 ± 1.48
Albumin (N=92)	Abnormal (< 3.5 g/dL)	4 (4.3)	16.44 ± 13.36	0.22	.965
	Normal (≥3.5 g/dL)	88 (95.7)	15.07 ± 12.21
		4.13 ± 0.37
A habit to warm body Tub bath (week)	Not 1~2	41 (31.3) 66 (50.4)	17.46 ± 14.5415.69 ± 14.31	0.15	.931
	3~4	15 (11.5)	15.42 ± 12.51
	≥5	9 (6.8)	17.01 ± 14.51
Foot bath (week)	Not	83 (63.4)	16.19 ± 14.20	0.11	.956
	1~23~4	27 (20.6) 14 (10.7)	16.07 ± 17.5018.19 11.52
	3~4	14 (10.7)	18.19 ± 11.52
	≥5	7 (5.3)	14.75 ± 13.39
Habit of warming	Not at all ^a	42 (32.1)	10.49 ± 7.95	5.33	.006
the usual limbs	Sometimes ^b	40 (30.5)	19.52 ± 15.39		(a＜ b,c)
	Often ^c	49 (37.4)	18.65 ± 16.72
Massage	Not at all ^a	39 (29.8)	10.19 ± 8.12	5.47	.005
	Sometimes ^b ^c	70 (53.4)	18.38 ± 15.42		(a＜ b,c)
	Often ^c	22 (16.8)	20.53 ± 17.31
Anxiety	Normal	85 (64.9)	14.00 ± 13.86	3.21	.044
	Mild	31 (23.7)	20.01 ± 14.54
	Moderate	15 (11.4)	21.66 ± 15.95
		6.79 ± 3.15
Depression	Normal ^a	88 (67.2)	13.35 ± 10.68	7.10	＜.001
	Mild ^b	20 (15.3)	19.13 ± 17.14		(a＜ c)
	Moderate ^c	23 (17.5)	25.15 ± 20.36
		6.50 ± 3.85

Table 3.

Correlation between Peripheral Neuropathy and Characteristics of Cancer Patients undergoing Chemotherapy (N =131)

Variables	CIPN	Age B	Basal cold hyper-sensitivity in the hands and feet	Physical activity	Nutrition and eating habits	Hb	Albumin	BMI	Anxiety	Depression
Variables	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
CIPN	1	-.07	.45	.00	-.01	-.07	-.18	.02	.24	.38
		(.427)	(＜.001)	(.973)	(.887)	(.427)	(.092)	(.802)	(.005)	(＜.001)

CIPN= Chemotherapy induced peripheral neuropathy; Hb= Hemoglobin; BMI= Body mass index.

Table 4.

Factors Influencing Peripheral Neuropathy of Cancer Patients undergoing Chemotherapy (N =131)

Variables	B	SE	β	t	p
Gender*	-9.92	3.48	-.34	-2.85	.005
Diabetes*	9.99	3.07	.23	3.26	＜.001
Basal sensory abnormality*	4.97	2.55	.17	1.95	.054
Basal cold hypersensitivity in the hands and feet	1.60	0.47	.29	3.44	＜.001
Depression	1.02	0.32	.27	3.17	.002
		Adjusted R²= 0.411, F= 7.99, p＜.001

^∗ Dummy variables.

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