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Falls in persons with chemotherapy-induced peripheral neuropathy

Support Care Cancer. 2012 Mar;20(3):583-9. doi: 10.1007/s00520-011-1127-7. Epub 2011 Mar 5.

Abstract

Purpose: The purpose of this study was to evaluate possible risk factors for falls in a group of patients with chemotherapy-induced peripheral neuropathy (CIPN).

Methods: This prospective, descriptive study included persons receiving paclitaxel, docetaxel, oxaliplatin, or cispatin who reported at least one symptom of CIPN. Each patient was invited to complete the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (CIPNAT) and a demographic data questionnaire. Data were analyzed using descriptive statistics and logistic regression.

Results: In this sample (n = 109), fallers (n = 21) had higher doses of chemotherapy(p = 0.045), more neuropathic symptoms (p = 0.016), higher scores on the symptom experience (p = 0.005) and interference items (=0.001) on the CIPNAT, more severe muscle weakness (p < 0.001) and loss of balance (p < 0.001), and higher interference with walking(p < 0.001) and driving (p = 0.022). Patients who received taxanes were more likely to have fallen than patients who received platinum-based chemotherapy (p = 0.022). No significant differences in age or disease stage between fallers and non-fallers were present. Severity of loss of balance and cycle number was independently associated with falling.

Conclusions: This study demonstrates that the risk of falls increases with each cycle of chemotherapy and that patients receiving taxanes may be at greater risk of falls than patients receiving neurotoxic platinum-based drugs. Patients who report muscle weakness and loss of balance or say that their symptoms interfere with walking or driving may be at a higher risk of falls.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Causality
  • Comorbidity
  • Docetaxel
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Muscle Weakness / chemically induced
  • Muscle Weakness / epidemiology
  • Neoplasm Staging
  • Neoplasms / classification
  • Neoplasms / drug therapy
  • Neoplasms / pathology
  • Organoplatinum Compounds / administration & dosage
  • Oxaliplatin
  • Paclitaxel / administration & dosage
  • Peripheral Nervous System Diseases / chemically induced*
  • Peripheral Nervous System Diseases / epidemiology*
  • Population Surveillance
  • Postural Balance
  • Prospective Studies
  • Risk Factors
  • Sensation Disorders / chemically induced
  • Sensation Disorders / epidemiology
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Taxoids / administration & dosage

Substances

  • Organoplatinum Compounds
  • Taxoids
  • Oxaliplatin
  • Docetaxel
  • Paclitaxel