A Comparative Assessment of Symptom Burden in Platinum- Induced Peripheral Neuropathy at a Tertiary Care Hospital in Chennai, Southern India

Abstract

Introduction: Peripheral neuropathy (PN) is a clinically significant and dose-limiting adverse effect of platinumbased chemotherapy regimens. It can impair patients’ quality of life and may necessitate dose modification or treatment discontinuation. This study aims to compare the symptom burden of PN among patients receiving these regimens and to identify which platinum-based regimen is most strongly associated with higher symptom severity, to facilitate early implementation of preventive measures to reduce symptom burden in future patients.

Materials and Methods: This six-month observational study at a tertiary care hospital in Chennai included 108 cancer patients receiving platinum-based regimens. Peripheral neuropathy was assessed using the EORTC QLQ-CIPN20. Data were analyzed using SPSS and Python. Group differences were evaluated using Mann–Whitney U or Kruskal–Wallis tests with Dunn’s post hoc test with Bonferroni correction, and ordinal logistic regression was used for univariate and multivariate analyses. A p-value <0.05 was considered significant.

Results: The overall symptom burden among the study population (N = 108) demonstrated a mean total score of 43.9 ± 19.33, with a median of 42.49 (IQR 28.25), indicating a moderate burden. Symptom burden scores were significantly different among the three platinum drug groups (p = 0.043), with higher scores in patients receiving carboplatin-based regimens. Regimens that included paclitaxel caused a notably higher symptom burden (p = 0.007). There were also significant differences across different regimens (p = 0.003), with the paclitaxel–carboplatin (PC) regimen showing the highest burden, likely due to the combined neurotoxic effects of both drugs.

Conclusion: This study highlights the importance of early implementation of neuroprotective interventions in patients receiving the paclitaxel–carboplatin (PC) regimen, given its association with the highest neuropathy burden. The findings underscore the value of regimen selection and individualized supportive care strategies to minimize symptom burden and preserve patients’ quality of life.