The impact of obesity on neuropathy outcomes for paclitaxel- and oxaliplatin-treated cancer survivors
Menée en Australie à partir de données portant sur 379 patients ayant survécu à un cancer, cette étude analyse l'effet de l'obésité sur la sévérité d'une neuropathie périphérique induite par une chimiothérapie à base de paclitaxel et d'oxaliplatine
Purpose : Chemotherapy-induced peripheral neuropathy (CIPN) is a major side effect of neurotoxic cancer treatment, often impacting treatment tolerability and patient functioning. Factors predicting an individual’s vulnerability for developing CIPN remain ill-defined. However, patient characteristics may contribute to CIPN risk, with obesity being a prevalent patient comorbidity. This study was aimed at evaluate if being overweight (BMI ≥ 25 kg/m2) was associated with worse symptomatic, clinical, and functional CIPN following neurotoxic cancer treatment. Methods : Three hundred seventy-nine cancer survivors were assessed 5 (IQR 3–5) months post oxaliplatin or paclitaxel treatment via comprehensive patient-reported, clinical, and functional CIPN measures. Patients classified as overweight (BMI ≥ 25 kg/m2) were compared to those within the normal BMI range (< 25 kg/m2). Multilinear regression was conducted to evaluate the association between patient clinical factors and CIPN severity. Results : Most patients reported CIPN symptoms (78%), with deficits evident on clinical examination. Overweight patients (n = 242, 63.8%) had significantly worse CIPN across symptomatic, objective clinical, and functional outcomes compared to those with a normal BMI (p < .05). In multivariate linear regression, older age (B = .088, 95%CI = .053–.122, p < .001), larger waist circumference (B = .030, 95%CI = .001–.059, p < .05), and larger BSA (B = 2.41, 95%CI = .34–04.48, p < .05) were associated with CIPN. Diabetes and BMI were significant on univariate analysis but not in the final models. Conclusions : Overweight patients represent a large proportion of cancer survivors who may be particularly impacted by CIPN, requiring closer monitoring and referral to supportive services. Accessible data such as a patient’s general and abdominal obesity status may aid in formulating personalized treatment. Implications for Cancer Survivors : Identifying routinely measured patient characteristics which may contribute to an individual’s CIPN risk profile could assist with informing treatment decisions.