Chemotherapy-induced Moderate to Severe Peripheral Neuropathy in Patients Receiving Adjuvant Radiotherapy for Breast Cancer.

Background/aim: A significant number of breast cancer patients assigned to adjuvant radiotherapy receive pre- or postoperative chemotherapy that can cause peripheral sensory and autonomic neuropathy (PNP). Identifying and grading PNP using a mobile application (app) may facilitate early detection and management. This study evaluated the prevalence of pre-radiotherapy PNP, providing essential baseline data for the prospective validation of such an app.

Patients and methods: Data of 133 breast cancer patients receiving chemotherapy prior to adjuvant radiotherapy were retrospectively analyzed regarding the incidence and risk factors of chemotherapy-induced moderate to severe PNP.

Results: The incidence of moderate to severe PNP was 27.8%. On multivariate analysis, it was significantly associated with KPS ≤80 (p=0.030), history of significant cardiovascular disease (p=0.024), ≥10 pack years of smoking (p=0.023), and beta blocker medication (p=0.014). A trend was found for history of autoimmune disease (p=0.057).

Conclusion: A considerable proportion of breast cancer patients assigned for adjuvant radiotherapy experienced moderate to severe PNP, which radiation oncologists should be aware of. The risk factors identified in this study likely contribute to earlier detection of PNP and inform the development of a prospective trial to validate a mobile-based PNP assessment tool.