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ChemotherapyInducedPeripheralNeuropathyLinkedTo

PatientFalls

Neurologicalsideeffectsoftaxaneandplatinumchemotherapymayincreasetheriskoffalling
Date:18May2016
Author:ByLyndaWilliams,SeniormedwireNewsReporter

medwireNews:Patientswithchemotherapyinducedperipheralneuropathy(CIPN)areathighriskoffalling,
suggestsresearchpublishedinJAMANeurology.

Of116patientsbeginningneurotoxictaxaneorplatinumchemotherapyforbreast,ovarianorlungcancer,
the32patientswithCIPNsymptomswereasignificant2.67timesmorelikelytoreportafalloranearfall
thanthosewithoutthesesideeffects.

Thisnearly3foldincreaseinriskisparticularlystrikinggiventhatpatientswithcanceralreadyhavean
elevatedriskoffalling,sayNoahKolb,fromtheUniversityofUtahSchoolofMedicineinSaltLakeCity,
USA,andcoauthors.

Thepatients,whowereagedanaverageof55.5years,wereaskedtouseanautomatedtelephoneservice
toreportCIPNsymptomsdailyduringacourseofchemotherapy.CIPNsymptomswereconsidered
significantifthepatientdescribednumbnessortinglingataseverityscoreof3oraboveona10pointscale
foratleast10days.

Overanaverageof62days,37fallsand37nearfallswererecordedin24participants.Theseoccurredin
34.3%ofpatientswithCIPNversus15.4%ofpatientsnotaffectedbyCIPN,givingahazardratio(HR)of
2.67afteradjustingforage,genderandlengthoffollowup.

Increasingagewasalsosignificantlyassociatedwithagreaterfallrisk,ataHRof1.27per5yearincrease
inage,theresearchersnote.

Overthewholereportingperiod,patientswhofellhadahighermeanscorefornumbnessandtingling
severitythanthosewhodidnot(1.5vs0.7)andexperiencedthesesymptomsmoreoften(18.0vs9.1days).
Therewasamodestcorrelationbetweennumberoffallsperparticipantandnumbnessandtinglingseverity
scores,theteamadds.

Notingthat18.8%ofpatientswithCIPNrequiredmedicalattentionforafall,versus9.5%ofasymptomatic
patients,NoahKolbetalsummarise:TheCIPNrelatedfallsandtheassociatedinjuriesincreasetheuseof
healthcareresourcesandreducequalityoflife.

FurtherresearchisneededtoelucidatethebeststrategiestoidentifypatientswithCIPNearlyand
intervenetopreventfallsamongthisvulnerablepopulation.

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