A prospective study on the incidence and severity of paclitaxel induced peripheral neuropathy in indian population

Abstract

In spite of the high efficacy rate of paclitaxel, physicians are compelled to discontinue the regimen due to its prevailing neurotoxicity and myelosuppressive effects, thus not being able to achieve the desired clinical outcomes. The neurotoxicity studies of paclitaxel have been mostly done on upper dose limits (>275mg/m2), and little information is available on lower doses. Since there is a lack of such studies in the Indian population, the medical professionals are unable to analyze at what cumulative dose does paclitaxel show maximum severity of peripheral neuropathy. This is a prospective observational study conducted for a period of 1 year in patients undergoing paclitaxel therapy. These patients were evaluated for the incidence and severity of paclitaxel induced peripheral neuropathy during the first 6 cycles using the QLQ-CIPN questionnaire. We also identified the cumulative dose at which most patients developed peripheral neuropathy and each patient’s quality of life using EORTC QLQ C30. Out of 85 patients, 76 developed peripheral neuropathy during the first 6 cycles. It was observed that the severity of peripheral neuropathy was increasing in each cycle of therapy. The overall quality of life of patients was decreasing with therapy, and at a cumulative dose of 525mg/m2 most of the patients (40%) developed symptoms of peripheral neuropathy. The incidence and severity of peripheral neuropathy increased with each cycle, and this has led to a significant reduction in the quality of life of patients post 6 cycles; and also, a high cumulative dose may limit the paclitaxel therapy.