Paclitaxel-induced peripheral neuropathy in patients receiving adjuvant chemotherapy for breast cancer

The long-term outcomes and risk factors of paclitaxel-induced peripheral neuropathy (PIPN) have not yet been fully elucidated.

We identified 219 breast cancer patients who received paclitaxel as adjuvant chemotherapy between 2002 and 2009. We retrospectively analyzed the incidence, time to onset, duration, and risk factors for PIPN by chart review.

Of the 219 patients, 212 developed PIPN (97%) during a median follow-up time of 57 months (range 5.3-95.5). Median time to PIPN onset was 21 days (range 11-101) for the entire patient population: 35 days (range 14-77) for weekly administration and 21 days (range 11-101) for tri-weekly administration. PIPN caused termination of paclitaxel treatment in 7 patients (4%). Median duration of PIPN was 727 days (range 14-2621 days). PIPN persisted in 64 and 41% of patients at 1 and 3 years after initiating paclitaxel, respectively. Age ≥60 years and severity of PIPN were significantly associated with PIPN duration.

PIPN persists longer in older patients and in those who experience severe neuropathy. Further studies to identify the risk factors for PIPN are warranted.