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Neurotoxicity of taxanes: Symptoms and quality of life assessment

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Abstract

Paclitaxel (TXL) and docetaxel (TXT), especially TXL, cause neurotoxicity manifested as polyneuropa-thy. In clinical practice, detailed knowledge of the symptoms and effect on quality of life (QOL) of neurotoxicity is crucially important both for diagnosis of neuropathy and for management of patients treated with taxanes. In this review, we summarize the symptoms of neurotoxicity caused by taxanes, and highlight the importance of QOL assessment in breast cancer patients treated with taxanes. The most common feature of taxane neurotoxicity is a predominant sensory distal neuropathy, and the incidence and severity of the neuropathic manifestations appear to be related to dose level and cumulative dose. A mixture of paresthesias and dysesthesias is often prominent, and the complaints include burning dysesthesia, numbness, tingling, and shooting pains, typically in a stocking-glove distribution. In contrast to sensory disturbances, motor neuropathy is not well recognized, and is believed to be much less common than sensory neuropathy. Weakness is usually mild, and distal motor neuropathy caused by taxanes rarely affects patients’ activities of daily living. The effect of neurotoxicity on QOL is not fully understood, as no study has specifically assessed QOL in terms of neurotoxicity. There is therefore a clear need to collect more detailed data about QOL using well validated, reliable instruments. This will enable us to provide the information that patients require when treatment decisions are being made, and will help in the pursuit of the ameliorative interventions.

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Abbreviations

AC:

Doxorubicin and cyclophoshamide

ADL:

Activities of daily living

CPK:

Creatine phosphokinase

CSPOR:

Comprehensive Support Project for Oncological Research of Breast Cancer

EORTC QLQ:

European Organization for Research and Treatment of Cancer Quality of Life Questionnaire

EQ-5D:

EuroQOL 5 Dimension

FACT:

Functional Assessment of Cancer Therapy

HOR:

Health Outcome Research

N-SAS BC:

National Surgical Adjuvant Study of Breast Cancer

NTX:

Physician neurotoxicity examination form

PNQ:

Patient neurotoxicity questionnaire form

QOL:

Quality of life

QOL-ACD:

Quality of Life Questionnaire for Cancer Patients Treated with Anticancer Drugs

TXL:

Paclitaxel

TXT:

Docetaxel

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Authors and Affiliations

  1. Department of Surgery, Showa University, Toyosu Hospital, 4-1-18 Toyosu, 135-8577, Koutou-ku, Tokyo, Japan

    Katsumasa Kuroi

  2. Department of Hospital and Welfare Service, Faculty of Service Industries, University of Marketing and Distribution Sciences, Japan

    Kojiro Shimozuma

  3. Institute for Scientific Research of Stress, Public Health Research Foundation, Japan

    Kojiro Shimozuma

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  1. Katsumasa Kuroi
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Kuroi, K., Shimozuma, K. Neurotoxicity of taxanes: Symptoms and quality of life assessment. Breast Cancer 11, 92–99 (2004). https://doi.org/10.1007/BF02968010

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