Blogger's Opinion: since this journal is a publication of the ACS then open access should be mandated
Further data supporting that paclitaxel-associated acute pain syndrome is associated with development of peripheral neuropathy
Abstract
BACKGROUND:
Paclitaxel
causes an acute pain syndrome (P-APS), occurring within days after each
dose and usually abating within days. Paclitaxel also causes a more
classic peripheral neuropathy, which steadily increases in severity with
increasing paclitaxel total doses. Little detail is available regarding
the natural history of these 2 syndromes, or any relationship between
them, although a recent publication does provide natural history data
about weekly paclitaxel, supporting an association between the severity
of P-APS and eventual peripheral neuropathy symptoms.
METHODS:
Patients
entering this study were about to receive paclitaxel and carboplatin
every 3 weeks. Daily questionnaires were completed for the first week
after every chemotherapy dose, and European Organization for Research
and Treatment of Cancer, Quality of Life Questionnaire,
Chemotherapy-Induced Peripheral Neuropathy 20-item instruments were
completed weekly.
RESULTS:
The
P-APS severity peaked on day 4 after the initial chemotherapy dose,
with 12%, 29%, 23%, and 36% of patients having maximal pain scores of 0,
1 to 4, 5 or 6, or 7 to 10 during the first week after the first dose
of therapy, respectively. Patients with P-APS scores of 0 to 4 with the
first dose of chemotherapy had less eventual sensory neuropathy than did
patients with P-APS scores of 5 to 10 (P = 0.001). With regard
to the more peripheral neuropathy, sensory neuropathy was more
problematic than was either motor or autonomic neuropathy. Numbness and
tingling were more common components of the sensory neuropathy than was
pain.
CONCLUSIONS:
Patients
with worse P-APS severities appear to have more eventual
chemotherapy-induced peripheral neuropathy. This provides support for
the concept that P-APS is a form of nerve pathology.
