Associations Between Chemotherapy-Induced Peripheral Neuropathy and Distress in Patients Assigned to Adjuvant Irradiation for Non-Metastatic Breast Cancer
Abstract
1. Introduction
2. Materials and Methods
Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Abbreviation | Chemotherapy Regimen |
---|---|
EC + PAC |
|
EC + PAC/Carbo |
|
EC + PAC/Carbo + Pembro |
|
APT |
|
ETC |
|
TCbHP |
|
Characteristic | n Patients | (%) |
---|---|---|
Peripheral sensory neuropathy | ||
No | 37 | 37.8 |
Mild | 35 | 35.7 |
Moderate to severe | 26 | 26.5 |
Time of chemotherapy | ||
Neoadjuvant | 59 | 60.2 |
Adjuvant | 39 | 39.8 |
Type of surgery | ||
Breast-conserving surgery | 75 | 76.5 |
Mastectomy | 23 | 23.5 |
Age | ||
≤64 years | 81 | 82.7 |
≥65 years | 17 | 17.3 |
Karnofsky performance status | ||
≤80 | 25 | 25.5 |
90–100 | 73 | 74.5 |
Body mass index | ||
<25.0 kg/m2 | 41 | 41.8 |
25.0–29.9 kg/m2 | 31 | 31.6 |
≥30 kg/m2 | 26 | 26.5 |
Personal status | ||
Living with spouse or partner | 73 | 74.5 |
Single/widow/living alone | 25 | 25.5 |
History of other malignancy | ||
No | 90 | 91.8 |
Yes | 8 | 8.2 |
Type of chemotherapy | ||
EC + PAC | 32 | 32.7 |
EC + PAC/Carbo | 14 | 14.3 |
EC + PAC/Carbo + Pembro | 18 | 18.4 |
APT | 5 | 5.1 |
ETC | 8 | 8.2 |
TCbHP | 21 | 21.4 |
Autoimmune disease | ||
No | 80 | 81.6 |
Yes | 18 | 18.4 |
Significant cardiovascular disease | ||
No | 92 | 93.9 |
Yes | 6 | 6.1 |
Hypertension | ||
No | 67 | 68.4 |
Yes | 31 | 31.6 |
Diabetes | ||
No | 92 | 93.9 |
Yes | 6 | 6.1 |
History of smoking | ||
<10 pack years | 69 | 70.4 |
≥10 pack years | 29 | 29.6 |
Beta-blocker medication | ||
No | 85 | 86.7 |
Yes | 13 | 13.3 |
Main histology | ||
No special type alone | 85 | 86.7 |
Other | 13 | 13.3 |
Histologic grading | ||
G1 or G2 | 34 | 34.7 |
G3 | 64 | 65.3 |
Triple-negativity | ||
No | 73 | 74.5 |
Yes | 25 | 25.5 |
Characteristics Compared in the Statistical Analysis | Mean Distress Score (±SD) | Median Distress Score (Q1–Q3) | p-Value |
---|---|---|---|
Peripheral sensory neuropathy | 0.003 | ||
No | 4.04 (2.24) | 4.0 (2.0–5.0) | |
Mild | 4.21 (2.54) | 4.0 (2.0–6.0) | |
Moderate to severe | 6.17 (2.41) | 6.25 (5.0–8.0) | |
Peripheral sensory neuropathy | <0.001 | ||
No or mild | 4.13 (2.38) | 4.0 (2.0–5.75) | |
Moderate to severe | 6.17 (2.41) | 6.25 (5.0–8.0) | |
Time of chemotherapy | 0.247 | ||
Neoadjuvant | 5.09 (2.68) | 5.0 (3.0–8.0) | |
Adjuvant | 4.39 (2.43) | 5.0 (2.5–6.5) | |
Type of surgery | 0.608 | ||
Breast-conserving surgery | 4.57 (2.51) | 5.0 (2.5–6.5) | |
Mastectomy | 5.00 (2.67) | 5.0 (3.0–8.0) | |
Age | 0.056 | ||
≤64 years | 4.43 (2.41) | 5.0 (2.5–6.0) | |
≥65 years | 5.82 (2.88) | 6.0 (4.0–8.0) | |
Karnofsky performance status | 0.001 | ||
≤80 | 6.22 (2.40) | 6.0 (4.5–8.0) | |
90–100 | 4.14 (2.38) | 4.0 (2.0–5.5) | |
Body mass index | 0.131 | ||
<25.0 kg/m2 | 4.01 (2.18) | 3.5 (2.0–5.5) | |
25.0–29.9 kg/m2 | 5.08 (2.88) | 5.0 (2.5–8.0) | |
≥30 kg/m2 | 5.21 (2.51) | 5.0 (3.0–7.0) | |
Personal status | 0.436 | ||
Living with spouse or partner | 4.56 (2.63) | 5.0 (3.0–6.5) | |
Single/widow/living alone | 4.98 (2.28) | 5.0 (3.0–6.0) | |
History of other malignancy | 0.231 | ||
No | 4.57 (2.50) | 5.0 (2.5–6.5) | |
Yes | 5.81 (2.87) | 5.25 (4.0–8.25) | |
Type of chemotherapy | 0.078 | ||
EC + PAC | 4.61 (2.67) | 4.5 (2.25–7.25) | |
EC + PAC/Carbo | 6.04 (2.37) | 5.75 (5.0–8.0) | |
EC + PAC/Carbo + Pembro | 3.83 (2.15) | 3.0 (2.0–5.0) | |
APT | 5.10 (2.88) | 6.0 (2.5–6.0) | |
ETC | 6.06 (1.99) | 5.5 (4.75–7.0) | |
TCbHP | 3.93 (2.51) | 4.0 (2.5–5.0) | |
Chemotherapy including carboplatin | 0.374 | ||
No | 4.92 (2.59) | 5.0 (3.0–7.0) | |
Yes | 4.45 (2.50) | 5.0 (3.0–6.0) | |
Autoimmune disease | 0.035 | ||
No | 4.39 (2.47) | 5.0 (2.5–6.0) | |
Yes | 5.89 (2.56) | 6.0 (4.5–8.0) | |
Significant cardiovascular disease | 0.324 | ||
No | 4.61 (2.57) | 5.0 (2.5–6.5) | |
Yes | 5.58 (2.01) | 5.5 (4.0–7.0) | |
Hypertension | 0.002 | ||
No | 4.11 (2.35) | 3.5 (2.0–6.0) | |
Yes | 5.87 (2.55) | 5.5 (5.0–8.0) | |
Diabetes | 0.270 | ||
No | 4.59 (2.47) | 5.0 (2.75–6.25) | |
Yes | 5.83 (3.54) | 6.5 (4.0–9.0) | |
History of smoking | 0.151 | ||
<10 pack years | 4.41 (2.55) | 5.0 (2.0–6.5) | |
≥10 pack years | 5.28 (2.47) | 5.0 (3.5–6.5) | |
Beta-blocker medication | 0.072 | ||
No | 4.48 (2.47) | 5.0 (2.5–6.0) | |
Yes | 5.92 (2.75) | 6.0 (5.0–8.0) | |
Main histology | 0.293 | ||
No special type alone | 4.54 (2.46) | 5.0 (3.0–6.0) | |
Other | 5.50 (3.01) | 5.0 (2.5–8.0) | |
Histologic grading | 0.905 | ||
G1 or G2 | 4.74 (2.59) | 4.5 (3.0–6.5) | |
G3 | 4.63 (2.53) | 5.0 (2.5–6.5) | |
Triple-negativity | 0.254 | ||
No | 4.49 (2.60) | 5.0 (2.5–6.0) | |
Yes | 5.18 (2.32) | 5.0 (3.0–7.0) |
Characteristics Compared in the Statistical Analysis | Least-Square Mean | 95% Confidence Interval | p-Value * |
---|---|---|---|
Peripheral sensory neuropathy | 0.099 | ||
No | 5.0 | 3.74–6.25 | |
Mild | 5.3 | 3.98–6.55 | |
Moderate to severe | 6.4 | 5.39–7.47 | |
Age | 0.859 | ||
≤64 years | 5.5 | 4.61–6.39 | |
≥65 years | 5.6 | 4.18–7.08 | |
Karnofsky performance status | 0.012 | ||
≤80 | 6.4 | 5.27–7.51 | |
90–100 | 4.7 | 3.56–5.92 | |
Body mass index | 0.760 | ||
<25.0 kg/m2 | 5.6 | 4.41–6.75 | |
25.0–29.9 kg/m2 | 5.8 | 4.66–6.96 | |
≥30 kg/m2 | 5.3 | 3.99–6.62 | |
Type of chemotherapy | 0.262 | ||
EC + PAC | 5.3 | 4.03–6.59 | |
EC + PAC/Carbo | 6.5 | 5.07–7.99 | |
EC + PAC/Carbo + Pembro | 4.7 | 3.31–6.14 | |
APT | 5.1 | 3.07–7.16 | |
ETC | 6.5 | 4.68–8.34 | |
TCbHP | 5.2 | 3.93–6.47 | |
Autoimmune disease | 0.503 | ||
No | 5.3 | 4.41–6.28 | |
Yes | 5.8 | 4.44–7.13 | |
Hypertension | 0.049 | ||
No | 4.9 | 3.55–6.22 | |
Yes | 6.3 | 5.26–7.23 | |
History of smoking | 0.185 | ||
<10 pack years | 5.2 | 4.24–6.18 | |
≥10 pack years | 5.9 | 4.72–7.12 | |
Beta-blocker medication | 0.398 | ||
No | 5.9 | 5.10–6.80 | |
Yes | 5.2 | 3.52–6.84 |
Characteristics Compared in the Statistical Analysis | Least-Square Mean | 95% Confidence Interval | p-Value * |
---|---|---|---|
Peripheral sensory neuropathy | 0.036 | ||
No or mild | 5.1 | 3.98–6.27 | |
Moderate to severe | 6.4 | 5.39–7.46 | |
Age | 0.872 | ||
≤64 years | 5.7 | 4.85–6.58 | |
≥65 years | 5.8 | 4.44–7.23 | |
Karnofsky performance status | 0.013 | ||
≤80 | 6.6 | 5.52–7.65 | |
90–100 | 4.9 | 3.82–6.11 | |
Body mass index | 0.726 | ||
<25.0 kg/m2 | 5.8 | 4.63–6.93 | |
25.0–29.9 kg/m2 | 6.0 | 4.92–7.16 | |
≥30 kg/m2 | 5.5 | 4.26–6.76 | |
Type of chemotherapy | 0.269 | ||
EC + PAC | 5.5 | 4.29–6.76 | |
EC + PAC/Carbo | 6.7 | 5.33–8.14 | |
EC + PAC/Carbo + Pembro | 4.9 | 3.60–6.33 | |
APT | 5.3 | 3.28–7.32 | |
ETC | 6.7 | 4.92–8.52 | |
TCbHP | 5.4 | 4.13–6.68 | |
Autoimmune disease | 0.505 | ||
No | 5.6 | 4.65–6.46 | |
Yes | 6.0 | 4.70–7.29 | |
Hypertension | 0.045 | ||
No | 5.1 | 3.81–6.36 | |
Yes | 6.4 | 5.50–7.43 | |
History of smoking | 0.174 | ||
<10 pack years | 5.4 | 4.48–6.35 | |
≥10 pack years | 6.1 | 4.99–7.29 | |
Beta-blocker medication | 0.405 | ||
No | 6.2 | 5.29–7.02 | |
Yes | 5.4 | 3.81–6.99 |
Problem | No n (%) | Mild n (%) | Moderate to Severe n (%) | FDR p-Value |
---|---|---|---|---|
Child care | 1 (2.7) | 0 (0.0) | 2 (7.7) | 0.305 |
Housing | 3 (8.1) | 1 (2.9) | 1 (3.8) | 0.319 |
Insurance | 1 (2.7) | 2 (5.7) | 3 (11.5) | 0.218 |
Financial | 2 (5.4) | 6 (17.1) | 6 (23.1) | 0.106 |
Transportation | 0 (0.0) | 2 (5.7) | 4 (15.4) | 0.050 |
Work/school | 0 (0.0) | 0 (0.0) | 2 (7.7) | 0.132 |
Dealing with children | 1 (2.7) | 1 (2.9) | 2 (7.7) | 0.305 |
Dealing with partner | 1 (2.7) | 2 (5.7) | 2 (7.7) | 0.305 |
Family health issues | 0 (0.0) | 3 (8.6) | 3 (11.5) | 0.132 |
Depression | 3 (8.1) | 3 (8.6) | 6 (23.1) | 0.132 |
Fears | 15 (40.5) | 13 (37.1) | 13 (50.0) | 0.319 |
Nervousness | 12 (32.4) | 4 (11.6) | 6 (23.1) | 0.262 |
Sadness | 10 (27.0) | 10 (28.6) | 10 (38.5) | 0.282 |
Worry | 13 (35.1) | 14 (40.0) | 18 (69.2) | 0.033 |
Loss of interest in usual activities | 3 (8.1) | 9 (25.7) | 9 (34.6) | 0.033 |
Appearance | 5 (13.5) | 8 (22.9) | 6 (23.1) | 0.281 |
Bathing/dressing | 1 (2.7) | 3 (8.6) | 4 (15.4) | 0.132 |
Breathing | 2 (5.4) | 4 (11.4) | 5 (19.2) | 0.132 |
Changes in urination | 0 (0.0) | 3 (8.6) | 5 (19.2) | 0.033 |
Constipation | 4 (10.8) | 5 (14.3) | 3 (11.5) | 0.534 |
Diarrhea | 3 (8.1) | 6 (17.1) | 6 (23.1) | 0.132 |
Eating | 5 (13.5) | 7 (20.0) | 11 (42.3) | 0.033 |
Fatigue | 14 (37.8) | 15 (42.9) | 21 (80.8) | 0.012 |
Feeling swollen | 8 (21.6) | 7 (20.0) | 9 (34.6) | 0.262 |
Fevers | 1 (2.7) | 0 (0.0) | 2 (7.7) | 0.305 |
Getting around | 11 (29.7) | 11 (31.4) | 19 (73.1) | 0.012 |
Indigestion | 4 (10.8) | 9 (25.7) | 11 (42.3) | 0.025 |
Memory/concentration | 10 (27.0) | 12 (34.3) | 17 (65.4) | 0.022 |
Mouth sores | 4 (10.8) | 2 (5.7) | 6 (23.1) | 0.218 |
Nausea | 5 (13.5) | 2 (5.7) | 8 (30.8) | 0.132 |
Nose dry/congested | 13 (35.1) | 9 (25.7) | 12 (46.2) | 0.305 |
Pain | 13 (35.1) | 12 (34.3) | 15 (57.7) | 0.132 |
Sexual | 3 (8.1) | 2 (5.7) | 5 (19.2) | 0.218 |
Skin dry/itchy | 11 (29.7) | 12 (34.3) | 13 (50.0) | 0.132 |
Sleep | 17 (45.9) | 18 (51.4) | 15 (57.7) | 0.282 |
Tingling in hands/feet | 0 (0.0) | 23 (65.7) | 25 (96.2) | <0.001 |
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Rades, D.; Bartscht, T.; Rody, A.; Ballegaard, M. Associations Between Chemotherapy-Induced Peripheral Neuropathy and Distress in Patients Assigned to Adjuvant Irradiation for Non-Metastatic Breast Cancer. J. Pers. Med. 2025, 15, 248. https://doi.org/10.3390/jpm15060248
Rades D, Bartscht T, Rody A, Ballegaard M. Associations Between Chemotherapy-Induced Peripheral Neuropathy and Distress in Patients Assigned to Adjuvant Irradiation for Non-Metastatic Breast Cancer. Journal of Personalized Medicine. 2025; 15(6):248. https://doi.org/10.3390/jpm15060248
Chicago/Turabian StyleRades, Dirk, Tobias Bartscht, Achim Rody, and Martin Ballegaard. 2025. "Associations Between Chemotherapy-Induced Peripheral Neuropathy and Distress in Patients Assigned to Adjuvant Irradiation for Non-Metastatic Breast Cancer" Journal of Personalized Medicine 15, no. 6: 248. https://doi.org/10.3390/jpm15060248
APA StyleRades, D., Bartscht, T., Rody, A., & Ballegaard, M. (2025). Associations Between Chemotherapy-Induced Peripheral Neuropathy and Distress in Patients Assigned to Adjuvant Irradiation for Non-Metastatic Breast Cancer. Journal of Personalized Medicine, 15(6), 248. https://doi.org/10.3390/jpm15060248