title: Further data supporting that paclitaxel-associated acute pain syndrome is associated with development of peripheral neuropathy: North Central Cancer Treatment Group trial N08C1.
abstract: BACKGROUND
  Paclitaxel causes an acute pain syndrome (P-APS), occurring within days after each dose and usually abating within days. Paclitaxel also causes a more classic peripheral neuropathy, which steadily increases in severity with increasing paclitaxel total doses. Little detail is available regarding the natural history of these 2 syndromes, or any relationship between them, although a recent publication does provide natural history data about weekly paclitaxel, supporting an association between the severity of P-APS and eventual peripheral neuropathy symptoms.
  
  
  METHODS
  Patients entering this study were about to receive paclitaxel and carboplatin every 3 weeks. Daily questionnaires were completed for the first week after every chemotherapy dose, and European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire, Chemotherapy-Induced Peripheral Neuropathy 20-item instruments were completed weekly.
  
  
  RESULTS
  The P-APS severity peaked on day 4 after the initial chemotherapy dose, with 12%, 29%, 23%, and 36% of patients having maximal pain scores of 0, 1 to 4, 5 or 6, or 7 to 10 during the first week after the first dose of therapy, respectively. Patients with P-APS scores of 0 to 4 with the first dose of chemotherapy had less eventual sensory neuropathy than did patients with P-APS scores of 5 to 10 (P = 0.001). With regard to the more peripheral neuropathy, sensory neuropathy was more problematic than was either motor or autonomic neuropathy. Numbness and tingling were more common components of the sensory neuropathy than was pain.
  
  
  CONCLUSIONS
  Patients with worse P-APS severities appear to have more eventual chemotherapy-induced peripheral neuropathy. This provides support for the concept that P-APS is a form of nerve pathology.
authors.affiliation: Mayo Clinic Rochester, Rochester, MN 55905, USA.
authors.forename: Brandi N
authors.initials: BN
authors.lastname: Reeves
authors.forename: Shaker R
authors.initials: SR
authors.lastname: Dakhil
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Wolf
authors.forename: Kelli N
authors.initials: KN
authors.lastname: Burger
authors.forename: Arif
authors.initials: A
authors.lastname: Kamal
authors.forename: Nguyet A
authors.initials: NA
authors.lastname: Le-Lindqwister
authors.forename: Gamini S
authors.initials: GS
authors.lastname: Soori
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Jaslowski
authors.forename: Joseph
authors.initials: J
authors.lastname: Kelaghan
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Novotny
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Lachance
authors.forename: Charles L
authors.initials: CL
authors.lastname: Loprinzi
mesh_terms: D059787:Acute Pain / Q000139:chemically induced* / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000009:adverse effects*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced*; D011795:Surveys and Questionnaires; D013577:Syndrome
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel