title: Gait, balance, and patient-reported outcomes during taxane-based chemotherapy in early-stage breast cancer patients.
abstract: BACKGROUND
  Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting toxicity of several commonly used chemotherapy drugs including taxanes, vinca alkaloids, and platinum compounds. Development of CIPN is highly variable, both in self-reported symptoms and functional consequences, and can be severe enough to alter dose intensity.
  
  
  OBJECTIVE
  To describe the natural histories of both patient-reported symptoms of CIPN and functional impairments in breast cancer patients undergoing taxane-based chemotherapy.
  
  
  METHODS
  Thirty-three breast cancer patients (32 female/1 male; 47.8 ± 11.2 years; n = 17 stage II/n = 16 stage III) were enrolled. Patients completed self-reports of symptoms and function (e.g., EORTC QLQ-CIPN20) and objective measures of physical function (i.e., balance and gait testing) in an outpatient oncology clinic at five timepoints: (1) baseline-prior to starting chemotherapy, (2-4) before starting subsequent chemotherapy cycles, and (5) 1-3 months after receiving their last taxane infusion.
  
  
  RESULTS
  Significant negative changes in both patient-reported outcomes and objective functional measures were observed. Decreased balance was observed after the first chemotherapy cycle (28% increase in medial-lateral excursion of the center of pressure, p = 0.016) and progressed with cumulative exposure (43% increase, p < 0.001). Patients also demonstrated slower walking speeds (5% decrease, p = 0.003) as they progressed through treatment. These functional deficits were mirrored with increased patient-reported symptom severity for all EORTC QLQ-CIPN20 subscales (all p < 0.05).
  
  
  CONCLUSIONS
  This study longitudinally assessed patient-reported outcomes concurrently with balance and gait testing in patients undergoing taxane therapy. Taxane treatment was associated with the development of clinically relevant problems in both CIPN symptoms and patient function.
authors.affiliation: Department of Mechanical and Aerospace Engineering, The Ohio State University, 201 W. 19th Ave., Columbus, OH, 43210, USA. scott.monfort@osumc.edu.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Monfort
authors.affiliation: Center for Biostatistics, The Ohio State University, Columbus, OH, USA.
authors.forename: Xueliang
authors.initials: X
authors.lastname: Pan
authors.affiliation: Stefanie Spielman Comprehensive Breast Center, The Ohio State University, Columbus, OH, USA.
authors.forename: Robyn
authors.initials: R
authors.lastname: Patrick
authors.affiliation: Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Center, The Ohio State University, Columbus, OH, USA.
authors.forename: Bhuvaneswari
authors.initials: B
authors.lastname: Ramaswamy
authors.affiliation: Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Center, The Ohio State University, Columbus, OH, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Wesolowski
authors.affiliation: Department of Internal Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Naughton
authors.affiliation: Department of Oncology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Loprinzi
authors.affiliation: Department of Mechanical and Aerospace Engineering, The Ohio State University, 201 W. 19th Ave., Columbus, OH, 43210, USA.|School of Health & Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA.
authors.forename: Ajit M W
authors.initials: AMW
authors.lastname: Chaudhari
authors.affiliation: Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Center, The Ohio State University, Columbus, OH, USA.
authors.forename: Maryam B
authors.initials: MB
authors.lastname: Lustberg
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D001952:Bridged-Ring Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005684:Gait / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D000071066:Patient Reported Outcome Measures; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000503:physiopathology*; D004856:Postural Balance / Q000187:drug effects; D057566:Self Report; D043823:Taxoids / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane
keywords: Balance; Breast cancer; CIPN; Gait; Neuropathies; Taxane