title: Chemotherapy-induced peripheral neuropathy after neoadjuvant or adjuvant treatment of breast cancer: a prospective cohort study.
abstract: OBJECTIVE
  The purposes of this study were to estimate the incidence of chemotherapy-induced peripheral neuropathy (CIPN) and to identify its main determinants and impact in patient-reported outcomes.
  
  
  METHODS
  We performed a prospective cohort study including 296 patients with incident breast cancer submitted to chemotherapy, followed for 1 year. Patients with incident CIPN were reevaluated 6 months after this diagnosis. Relative risks (RR) with 95 % confidence intervals (95 % CI) were computed to quantify the relation between different clinical characteristics and the occurrence of CIPN, using Poisson regression. The variation of patient-reported outcomes between baseline and 1-year follow-up assessments was compared between patients with and without CIPN.
  
  
  RESULTS
  The cumulative incidence of CIPN in the first year after diagnosis was 28.7 % (95 % CI 23.8-34.1), and more than 80 % of the patients were still symptomatic after 6 months. Among the latter, there was a significant decrease in the median total neuropathy score, clinical version (7 versus 4) between the two periods. In multivariable analysis, the risk of CIPN was higher for treatment with docetaxel (cumulative doses ≤300 mg/m(2), RR = 6.96, 95 % CI 2.53-19.10; >300 mg/m(2), RR = 13.32; 95 % CI 4.11-43.14). Alcohol consumption and diabetes were not significantly associated with CIPN. There were no significant differences in the variation of patient-reported outcomes between the baseline and 1-year follow-up evaluations.
  
  
  CONCLUSIONS
  CIPN was frequent in this contemporary cohort of early-stage breast cancer patients and was strongly associated with docetaxel-based regimens. Symptoms persisted for at least 6 months in most patients, but severity was low and CIPN had no impact on patient-reported outcomes.
authors.affiliation: Portuguese Institute of Oncology of Porto, Rua Dr. António Bernardino de Almeida, 4200-075, Porto, Portugal.|EPIUnit-Institute of Public Health, University of Porto (ISPUP), Rua das Taipas, n 135, 4050-600, Porto, Portugal.
authors.forename: Susana
authors.initials: S
authors.lastname: Pereira
authors.affiliation: EPIUnit-Institute of Public Health, University of Porto (ISPUP), Rua das Taipas, n 135, 4050-600, Porto, Portugal.|Department of Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Fontes
authors.affiliation: Portuguese Institute of Oncology of Porto, Rua Dr. António Bernardino de Almeida, 4200-075, Porto, Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Sonin
authors.affiliation: Portuguese Institute of Oncology of Porto, Rua Dr. António Bernardino de Almeida, 4200-075, Porto, Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Dias
authors.affiliation: Portuguese Institute of Oncology of Porto, Rua Dr. António Bernardino de Almeida, 4200-075, Porto, Portugal.
authors.forename: Maria
authors.initials: M
authors.lastname: Fragoso
authors.affiliation: Department of Experimental Biology, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Institute for Molecular and Cell Biology (IBMC), University of Porto, Rua do Campo Alegre, n 823, 4150-180, Porto, Portugal.
authors.forename: José M
authors.initials: JM
authors.lastname: Castro-Lopes
authors.affiliation: EPIUnit-Institute of Public Health, University of Porto (ISPUP), Rua das Taipas, n 135, 4050-600, Porto, Portugal. nlunet@med.up.pt.|Department of Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. nlunet@med.up.pt.
authors.forename: Nuno
authors.initials: N
authors.lastname: Lunet
mesh_terms: D000277:Adjuvants, Pharmaceutic / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D063868:Patient Outcome Assessment; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced*; D011446:Prospective Studies; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000277:Adjuvants, Pharmaceutic; D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel
keywords: Breast neoplasm; Peripheral nerve injuries; Quality of life