Chemotherapy-Induced Peripheral Neuropathy (CIPN): Classification and Investigation of Assessment Tools to Identify Different CIPN Subgroups

Abstract

This thesis investigated assessment tools to identify patient subgroups according to different symptom profiles of chemotherapy-induced peripheral neurotoxicity (CIPN) and aimed to characterise the impact of CIPN on patient function, quality-of-life and sleep quality in neurotoxic chemotherapy-treated patients.

Chapter 3 examined the use of electrochemical skin conductance (ESC) via Sudoscan as a potential measure of autonomic function in patients with CIPN. However, the ESC values did not associate with any CIPN severity measures or the autonomic outcome measure.

Chapter 4 compared a range of upper-limb functional and neurophysiological measures of CIPN severity. Overall, two-third of patients with CIPN reported the presence of upper-limb symptoms and functional deficits, as demonstrated by reduced fine motor skills, sensory perception, and neurophysiological measures of the sensory median nerve.

In addition, differences in clinical symptom profiles of non-painful and painful CIPN were examined in Chapter 5, including the impact on symptom burden in chemotherapy-treated patients. One quarter of patients reported painful CIPN symptoms, whereby these patients also reported worse CIPN severity and greater behavioural changes, in comparison to patients with non-painful CIPN.

Finally, Chapter 6 explored the specific impact of CIPN on the sleep quality of patients with chronic CIPN. The results revealed that almost half of patients with poor sleep quality attributed it to CIPN symptoms, who also reported worse CIPN severity and neuropathic pain, as well as worse quality-of-life.

In summary, these studies demonstrated the need for patient subgrouping and importance of identifying the impact of CIPN on patient function in hopes of informing better supportive care and symptom management options for patients with CIPN long after the completion of their neurotoxic chemotherapy treatment.