Incidence and Risk Factors Associated with Platinum Derivative Chemotherapy-Induced Peripheral Neuropathy during Antineoplastic Treatment.
Level 3 - non-randomized controlled study
Retrospective observational cohort study
PubMed 41569175 · doi:10.31557/APJCP.2026.27.1.87
What was done
Medical records from 3,140 cancer patients treated with cisplatin (42.58%), carboplatin (32.67%), or oxaliplatin (24.75%) across 16,878 cycle evaluations were retrospectively analyzed over a two-year evaluation period. Routine pre-cycle assessments of platinum-induced sensory peripheral neuropathy (PSPN) using CTCAE v5.0 (grades 0–4) were evaluated alongside clinical factors (age, sex, BMI, body surface area, tumor stage, chemotherapy protocol, prior head/neck radiotherapy) and 48-month overall survival using chi-square tests, multinomial logistic regression, and Kaplan-Meier analyses.
What was found
Any event of PSPN was reported in 98.85% of evaluations, and 1,867 (11.16%) showed grade ≥2 PSPN interfering with activities of daily living (ADL). Risk of ADL-interfering PSPN was significantly increased by treatment with carboplatin or oxaliplatin (p < 0.001), ≥5 chemotherapy cycles (p < 0.001), BMI > 25 (p = 0.005), advanced T (p < 0.001), N (p = 0.025), and M (p = 0.010) stages, and co-administration with capecitabine (p = 0.021), paclitaxel (p = 0.027), or vinorelbine (p = 0.031). Overall survival over 48 months was 87.3% (2,741/3,140); ADL-interfering PSPN was associated with a 1.52-fold higher risk of death (95% CI 1.19–1.95, p = 0.001).
Why it matters
This study identifies specific clinical, staging, and polychemotherapy risk factors for severe platinum neurotoxicity and links functional sensory neuropathy with reduced overall survival.
Limits
Retrospective observational design subject to documentation and selection biases. The abstract conflates patient-level and evaluation-level denominators for incidence rates and does not report cumulative drug doses, pre-existing neuropathy or diabetes, or whether the survival analysis adjusted for cancer stage.
Cited by
- supports For certain chemotherapeutic agents, 80% to 90% of patients are expected to develop peripheral neuropathy.