Is advanced age associated with increased incidence and severity of chemotherapy-induced peripheral neuropathy? (original) (raw)

Abstract

Purpose

The current setting tested the hypothesis that advanced age would be strongly associated with increased incidence and severity of chemotherapy-induced peripheral neuropathy (CIPN).

Patients and methods

We prospectively studied 35 cancer patients treated with paclitaxel or cisplatin-based regimens for lung or breast cancer. All patients underwent a detailed clinical and electrophysiological evaluation for screening of CIPN at baseline, at the third, the sixth course of chemotherapy and up to 3 months after its cessation. Means of a modified Peripheral Neuropathy (PNP) score summarized the results of the clinical and electrophysiological study.

Results

Patients were divided according to their age in two groups (mean age difference, _p_=0.000) to those younger than 65 years (group I, _n_=18) and those older or equal than 65 years (group II, _n_=17). According to the clinical, neurological and electrophysiological variables of each patient, the incidence and severity of CIPN was determined and then compared between groups. The incidence of neurotoxicity was similar (_p=_0.869) between group I (9/18 patients, 50%) and group II (8/17 patients, 52.9%). Likewise, according to the mean PNP scores, the severity of CIPN was similar between age groups (_p=_0.897). The between-age-groups comparison of electrophysiological data revealed no significant differences in any of the motor or sensory conduction parameters examined.

Conclusion

Our study indicates that elderly cancer patients do not have greater risk of CIPN, whilst advanced age was not associated with worst severity of CIPN.

Access this article

Log in via an institution

Subscribe and save

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

The alternative text for this image may have been generated using AI.

Similar content being viewed by others

References

  1. Alberts DS, Noel JK (1995) Cispaltin-associated neurotoxicity: can it be prevented? Anticancer Drugs 6:369–383
    Google Scholar
  2. Argyriou AA, Chroni E, Koutras A et al (2005) Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology 64(1):26–31
    Google Scholar
  3. Argyriou AA, Polychronopoulos P, Koutras A et al Peripheral neuropathy induced by administration of cisplatin and paclitaxel-based chemotherapy. Could it be predicted? Support Care Cancer (in press)
  4. Balducci L, Corcoran MB (2000) Antineoplastic chemotherapy of the older cancer patient. Hematol Oncol Clin North Am 14(1):193–212
    Google Scholar
  5. Balducci L (2001) The geriatric cancer patient: equal benefit from equal treatment. Cancer Control 8(Suppl2):1–25
    Google Scholar
  6. Berger T, Malayeri R, Doppelbauer A et al (1997) Neurological monitoring of neurotoxicity induced by paclitaxel/cisplatin chemotherapy. Eur J Cancer 33(9):1393–1399
    Google Scholar
  7. Chaudhry V, Rowinsky EK, Sartorius SE et al (1994) Peripheral neuropathy from taxol and cisplatin combination chemotherapy: clinical and electrophysiological studies. Ann Neurol 35:304–311
    Google Scholar
  8. Dyck PJ, Thomas PK (eds) (1993) Peripheral neuropathy, 3rd edn, vol 2. WB Saunders, Philadelphia, PA, pp 1310–1317
  9. Extermann M (2000) Measuring co-morbidity in older cancer patients. Eur J Cancer 36(4):453–471
    Google Scholar
  10. Giovanazzi-Bannon S, Rademaker A, Lai G, Benson AB III (1994) Treatment tolerance of elderly cancer patients entered into phase II clinical trials: an Illinois Cancer Center study. J Clin Oncol 12(11):2447–2452
    Google Scholar
  11. Gridelli C, Perrone F, Monfardini S (1997) Lung cancer in the elderly. Eur J Cancer 33(14):2313–2314
    Google Scholar
  12. Kimmick GG, Balducci L (2000) Breast cancer and aging. Clinical interactions. Hematol Oncol Clin North Am 14(1):213–234
    Google Scholar
  13. Kimura J (2001) Electrodiagnosis in diseases of nerve and muscle, principles and practice, 3rd edn. Oxford University press, New York pp 91–166
    Google Scholar
  14. Kleyweg RP, Van der Meché FGA, Schmitz PIM (1991) Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain–Barré syndrome. Muscle Nerve 14:1103–1109
    Google Scholar
  15. Langer CJ, Manola J, Bernardo P et al (2002) Cisplatin-based therapy for elderly patients with advanced non-small-cell lung cancer: implications of Eastern Cooperative Oncology Group 5592, a randomized trial. J Natl Cancer Inst 94(3):173–181
    Google Scholar
  16. Lipton RB, Apfel SC, Dutcher JP et al (1989) Taxol produces a predominantly sensory neuropathy. Neurology 39:368–373
    Google Scholar
  17. Miller AB, Hoogstraten B, Staquet M, Winkler A (1981) Reporting results of cancer treatment. Cancer 47:207–214
    Google Scholar
  18. Panayiotopoulos CP, Chroni E (1996) F-waves in clinical neurophysiology: a review. Methodological issues and overall value in peripheral neuropathies. Electroencephalogr Clin Neurophysiol 101:365–374
    Google Scholar
  19. Perez EA, Vogel CL, Irwin DH, Kirshner JJ, Patel R (2001) Multicenter phase II trial of weekly paclitaxel in women with metastatic breast cancer. J Clin Oncol 19(22):4216–4223
    Google Scholar
  20. Pierelli L, Perillo A, Greggi S, Salerno G et al (1999) Erythropoietin addition to granulocyte colony-stimulating factor abrogates life-threatening neutropenia and increases peripheral-blood progenitor-cell mobilization after epirubicin, paclitaxel, and cisplatin combination chemotherapy: results of a randomized comparison. J Clin Oncol 17(4):1288
    Google Scholar
  21. Quasthoff S, Hartung HP (2002) Chemotherapy-induced peripheral neuropathy. J Neurol 249(1):9–17
    Google Scholar
  22. Sargent DJ, Goldberg RM, Jacobson SD et al (2001) A pooled analysis of adjuvant chemotherapy for resected colon cancer in elderly patients. N Engl J Med 345(15):1091–1097
    Google Scholar
  23. Silverberg E, Lubera J (1988) Cancer statistics. Cancer J 38:5–22
    Google Scholar
  24. Verdu E, Ceballos D, Vilches JJ, Navarro X (2000) Influence of aging on peripheral nerve function and regeneration. J Peripher Nerv Syst 5(4):191–208
    Google Scholar

Download references

Author information

Authors and Affiliations

  1. Department of Neurology–Laboratory of Clinical Neurophysiology, University of Patras Medical School, P.O. Box 1045, Rion, Patras, Greece
    Andreas A. Argyriou, Panagiotis Polychronopoulos, Philippos Gourzis & Elisabeth Chroni
  2. Department of Medicine-Division of Oncology, University of Patras Medical School, Rion, Patras, Greece
    Angelos Koutras, Gregoris Iconomou, Konstantinos Assimakopoulos & Haralabos P. Kalofonos

Authors

  1. Andreas A. Argyriou
  2. Panagiotis Polychronopoulos
  3. Angelos Koutras
  4. Gregoris Iconomou
  5. Philippos Gourzis
  6. Konstantinos Assimakopoulos
  7. Haralabos P. Kalofonos
  8. Elisabeth Chroni

Corresponding author

Correspondence toAndreas A. Argyriou.

Rights and permissions

About this article

Cite this article

Argyriou, A.A., Polychronopoulos, P., Koutras, A. et al. Is advanced age associated with increased incidence and severity of chemotherapy-induced peripheral neuropathy?.Support Care Cancer 14, 223–229 (2006). https://doi.org/10.1007/s00520-005-0868-6

Download citation

Keywords