Longitudinal associations of chemotherapy-induced peripheral neuropathy with psychological distress and health-related quality of life in colorectal cancer survivors: a prospective cohort study

PurposeColorectal cancer (CRC) survivors receiving oxaliplatin-based chemotherapy frequently develop chemotherapy-induced peripheral neuropathy (CIPN). This study investigated the impact of CIPN symptoms on psychological distress and health-related quality of life (HRQoL) among oxaliplatin-treated CRC survivors up to 5 years post-treatment.Methods124 CRC patients treated with oxaliplatin-based chemotherapy participating in a prospective cohort study were included in the longitudinal analyses. CIPN symptoms were measured at diagnosis (pre-treatment) and at 6 weeks and 6, 12, 24, and 60 months post-treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-CIPN20 (EORTC QLQ-CIPN20). Psychological distress, including anxiety and depressive symptoms, and HRQoL were measured at all post-treatment time points using the Hospital Anxiety and Depression Scale (HADS) and the EORTC QLQ-Core 30 (EORTC QLQ-C30), respectively. Confounder-adjusted longitudinal associations of CIPN symptoms with psychological distress and HRQoL were analysed with linear mixed regression models.ResultsCIPN symptoms in oxaliplatin-treated CRC patients were highest at 6 weeks post-treatment, thereafter gradually decreasing over time. More severe CIPN symptoms were longitudinally associated with more psychological distress (HADS), including both higher anxiety and depressive symptoms, and with worse global health/QoL and physical and social functioning and more fatigue (EORTC QLQ-C30).ConclusionCIPN symptoms, persisting over time among oxaliplatin-treated CRC survivors, were longitudinally associated with more psychological distress and lower HRQoL up to 5 years after chemotherapy treatment.Implications for Cancer SurvivorsCIPN symptoms following oxaliplatin-based chemotherapy have a long-lasting impact on CRC survivors. Research on interventions aimed at mitigating CIPN symptoms is warranted.