Quality of Life in Colorectal Cancer Patients with Oxaliplatin Induced Peripheral Neuropathy

Background: Oxaliplatin has demonstrated modest ac-tivity in patients with metastatic CRC, generating a response rate between 10% and 24%. Neurotoxicity is the most frequent dose limiting toxicity of oxaliplatin. Acute sensory neurotoxic-ity manifests as rapid onset of cold induced distal dysesthesia and/or paresthesia, sometimes accompanied by cold dependent muscular contractions of the extremities or the jaw. The symp-toms, often occurs during or shortly after infusion, are usually transient and mild. A cumulative sensory peripheral neuropathy may also develop with prolonged treatment with oxaliplatin , eventually causing superficial and deep sensory loss, sensory ataxia and functional impairment. Aim of Study: This study aimed at estimating QoL in CRC patients treated with oxaliplatin-based regimen and having neu-rotoxicity. Patients and Methods: In this cross-sectional study, 62 pa-tients with colorectal cancer treated with oxaliplatin-containing regimen were recruited from the Clinical Oncology Department Ain Shams University Hospitals. All consecutive patients were assessed by means of two questionnaires, the QLQ-CIPN20 for assessment of neuropathy and the QLQ-C30 core questionnaire for assessment of quality of life in cancer patients from the European Organization for Study and Treatment of Cancer after being translated to Arabic. Results: The sensory scale revealed that around 46% of the patients suffered little tingling in the fingers or hands (mild) and 21.0% had quite a bit (moderate). Almost 42% suffered little tingling toes or feet (mild) and 16% suffered quite a bit (moderate). Furthermore, 38.7% had little numbness in fingers or hands (mild) and 14.5% suffered quite a bit (moderate). Fur-thermore, in our study, motor scale revealed that patients who suffered “Quite a bit” (moderate) cramps in their hands were 6.45% while those with cramps in their feet were 16.1%. Also, 19.4% had a little (mild) struggle holding a pen and 4.8% had quite a bit (moderate) struggle holding their hands. Finally, the assessment of autonomic function in our study revealed that 47% had a little (mild) dizziness when standing up from a sitting or lying position and 7% had quite a bit (moderate) dizziness. 17.4% had a little (mild) blurred vision. Regarding erection function, 30.64 had quite a bit (moderate) difficulty getting or maintaining an erection while 19.35 had a little (mild) difficul-ty. Generally, the EORTC-QLQ questionnaire revealed overall moderate quality of life. One fifth or less suffered problems in role functioning followed by social and emotional functioning. Conclusion: The use of oxaliplatin as an anticancer agent mostly associated with neurological disorders, including motor, sensory, and some other autonomic disorders which significant-ly affects the quality of life of those patients. Chemotherapy induced peripheral neuropathy is also the most frequent reason for treatment discontinuation. Physicians should actively assess for CIPN in order to prevent chronic neuropathy.