DI-003 Paclitaxel-carboplatin induced peripheral neuropathy in ovarian cancer patients

Background

Administration of paclitaxel is associated with an increased survival rate in ovarian cancer patients. Despite the clinicians' efforts to minimise paclitaxel induced neurotoxicity, peripheral neuropathy still remains an important side effect which can additionally affect the quality of life.

Purpose

Evaluation of the incidence and management of paclitaxel induced polyneuropathy and quality of life of ovarian cancer patients.

Material and methods

Retrospectively, the medical records of 50 ovarian cancer patients (20–70 years) receiving paclitaxel and carboplatin as firstline therapy at the university clinic of oncology were reviewed. Patients received 175 mg/m² paclitaxel and AUC5 carboplatin every 3 weeks, for 6 cycles, during 2012–2014. The main outcome measures were evaluation of side effects from paclitaxel and carboplatin therapy and assessment of ECOG performance status in ovarian cancer patients.

Results

The average age of the women included in the study was 45 years. Among these, 22% developed neutropenia (<2 × 10⁹/L) with 82% being fully active to carry on with all pre-disease performance (ECOG 0) and 18% had performance status ECOG 1. 12% (n = 5, ECOG 0, n = 1, ECOG 1) developed thrombocytopenia (<130 × 10⁹/L) and 62% (n = 29, ECOG 0, n = 3, ECOG 1) of the patients suffered anaemia (<100 g/L). 72% (n = 36) of patients developed neurotoxicity, with 12% suffering severe neurotoxicity and were restricted in their strenuous physical activity (ECOG 1). A combination of side effects were registered: severe anaemia (<81 g/L), neutropenia (<2 × 10⁹/L) and severe neurotoxicity with performance status ECOG 1, severe anaemia (<81 g/L) and severe neurotoxicity, performance status ECOG 1 and severe neutropenia (<0.5 × 10⁹/L), severe thrombocytopenia (<50 × 10⁹/L) and severe anaemia (<81 g/L) with performance status ECOG 1.

Conclusion

Polyneuropathy remains a clinically significant and potential serious side effect with increasing relevance to survivors. Polyneuropathy can be present at least 2 years after ending chemotherapy with indications for permanent symptomatic therapy which can ease and improve the quality of life. Hence the impact of polyneuropathy on quality of life should be studied more extensively in order to enable doctors to design a treatment plan that includes palliative, supportive and curative interventions. No conflict of interest.