Prevalence and factors associated with chemotherapy induced peripheral neuropathy among adult patients with cancer at Mbarara Regional Cancer Centre: a cross sectional study

Abstract

Background Chemotherapy is a common modality used for management of cancers but some agents are known to cause peripheral neuropathy. Chemotherapy induced peripheral neuropathy (CIPN) refers to a disorder in structure and functionality of peripheral sensory, motor, and autonomic neurons triggered by the toxic effects of these drugs. CIPN is a common adverse drug reaction (ADR) caused by mainly platinum analogs, vinca alkaloids and taxanes. Severe CIPN can cause paresis, complete immobilization and disability. The objectives of this study were to determine the prevalence, factors associated with and evaluate treatment of CIPN among adult patients with cancer at Mbarara Regional Cancer Centre. Methods A cross-sectional study was conducted for a period of 2 months among adult patients with cancer receiving chemotherapy at Mbarara Regional Cancer Centre. Consecutive sampling technique was used to enroll 235 participants into the study. Data collection was done through patient interviews and file reviews. Assessment of the clinical features of CIPN was done using EORTC-QLQ-CIPN20 tool. SPSS version 27 was used for data entry and analysis. Results The prevalence of CIPN was 31.1%. The factors associated with occurrence of CIPN include age greater or equal to 60 years (aOR = 2.04, 95% CI: 1.07–3.91, p-value = 0.031), concurrent administration of non-chemotherapeutic neurotoxic drugs (aOR = 6.50, 95% CI: 1.64–9.36), past resolved neuropathy prior to initiation of chemotherapy (aOR = 6.99, 95% CI: 2.28–9.21). 30.1% of patients with CIPN received treatment and were managed with agents such as pregabalin, gabapentin, cachnerve, Nat B, neuroton, amitriptyline and vitamin B complex. The American Society of Clinical Oncology guideline recommends use of duloxetine for treatment of CIPN. Conclusion Nearly one-third of patients at Mbarara Regional Cancer Centre had CIPN. Patient age 60 years and above, past resolved neuropathy and concurrent administration of non-chemotherapeutic neurotoxic drugs are factors associated with occurrence of CIPN. Therefore, such patients require close monitoring for the symptoms of peripheral neuropathy so that appropriate treatment can be initiated promptly