{"doi":"10.6004/jnccn.2023.7083","title":"Impact of Pain on Symptom Burden in Chemotherapy-Induced Peripheral Neurotoxicity","abstract":"<jats:p><jats:bold>Background:</jats:bold> Chemotherapy-induced peripheral neurotoxicity (CIPN) affects the quality of life of cancer survivors. However, the impact of pain on symptom burden remains undefined. This study aimed to define differences in the clinical symptom profile of patients with painful and nonpainful CIPN. <jats:bold>Patients and Methods:</jats:bold> A total of 579 participants (median age, 59 years [IQR, 19 years]; F=66%) were assessed cross-sectionally 6 months posttreatment. CIPN severity was graded using multiple methods, including patient-reported outcome measures, a clinically graded scale (NCI-CTCAE), and a neurologic examination score. Participants were classified into subgroups based on patient symptom report, with painful CIPN characterized by the presence of shooting/burning pain, and nonpainful CIPN characterized by the presence of numbness or tingling without shooting/burning pain. Behavioral changes were assessed via structured patient interview regarding symptom impact on sleep, exercise, and treatment-seeking. <jats:bold>Results:</jats:bold> Among 579 participants, 24% (n=140) reported painful CIPN, 48% (n=280) reported nonpainful CIPN, and 28% (n=159) had no CIPN. Participants with painful CIPN demonstrated higher CIPN severity than those with nonpainful CIPN across multiple measures, including NCI-CTCAE, neurologic grading, and patient report (all <jats:italic>P</jats:italic>&lt;.05). Participants with painful CIPN were more likely to report that their symptoms affected their ability to exercise (<jats:italic>P</jats:italic>=.007), produced sleep impairment, and increased treatment-seeking behavior due to their symptoms (both <jats:italic>P</jats:italic>&lt;.001) compared with participants with nonpainful CIPN. <jats:bold>Conclusions:</jats:bold> Overall, participants with painful CIPN reported higher scores across all CIPN severity measures, including behavioral changes. This study underlines the need for accurate identification of different CIPN subgroups in hopes of informing better treatment and rehabilitation options for cancer survivors with painful CIPN.</jats:p>","journal":"Journal of the National Comprehensive Cancer Network","year":2024,"id":645051,"datarank":0.3596842909197557,"base_score":2.3978952727983707,"endowment":2.3978952727983707,"self_citation_contribution":0.3596842909197557,"citation_network_contribution":0.0,"self_endowment_contribution":0.3596842909197557,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":955570,"name":"Tiffany Li","orcid":null,"position":1,"is_corresponding":false},{"id":1679401,"name":"Hannah C. Timmins","orcid":null,"position":2,"is_corresponding":false},{"id":263990,"name":"Lisa G. Horvath","orcid":"0000-0001-6842-9223","position":3,"is_corresponding":false},{"id":437331,"name":"Michelle Harrison","orcid":"0000-0001-9205-1961","position":4,"is_corresponding":false},{"id":1679404,"name":"Peter Grimison","orcid":null,"position":5,"is_corresponding":false},{"id":278299,"name":"Gavin Marx","orcid":"0000-0002-1016-6544","position":6,"is_corresponding":false},{"id":1061,"name":"David Goldstein","orcid":null,"position":7,"is_corresponding":false},{"id":745880,"name":"Susanna B. Park","orcid":"0000-0003-0218-4707","position":8,"is_corresponding":false},{"id":1679398,"name":"Fawaz Mayez Mahfouz","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Impact of Pain on Symptom Burden in Chemotherapy-Induced Peripheral Neurotoxicity","abstract":"<jats:p><jats:bold>Background:</jats:bold> Chemotherapy-induced peripheral neurotoxicity (CIPN) affects the quality of life of cancer survivors. However, the impact of pain on symptom burden remains undefined. This study aimed to define differences in the clinical symptom profile of patients with painful and nonpainful CIPN. <jats:bold>Patients and Methods:</jats:bold> A total of 579 participants (median age, 59 years [IQR, 19 years]; F=66%) were assessed cross-sectionally 6 months posttreatment. CIPN severity was graded using multiple methods, including patient-reported outcome measures, a clinically graded scale (NCI-CTCAE), and a neurologic examination score. Participants were classified into subgroups based on patient symptom report, with painful CIPN characterized by the presence of shooting/burning pain, and nonpainful CIPN characterized by the presence of numbness or tingling without shooting/burning pain. Behavioral changes were assessed via structured patient interview regarding symptom impact on sleep, exercise, and treatment-seeking. <jats:bold>Results:</jats:bold> Among 579 participants, 24% (n=140) reported painful CIPN, 48% (n=280) reported nonpainful CIPN, and 28% (n=159) had no CIPN. Participants with painful CIPN demonstrated higher CIPN severity than those with nonpainful CIPN across multiple measures, including NCI-CTCAE, neurologic grading, and patient report (all <jats:italic>P</jats:italic>&lt;.05). Participants with painful CIPN were more likely to report that their symptoms affected their ability to exercise (<jats:italic>P</jats:italic>=.007), produced sleep impairment, and increased treatment-seeking behavior due to their symptoms (both <jats:italic>P</jats:italic>&lt;.001) compared with participants with nonpainful CIPN. <jats:bold>Conclusions:</jats:bold> Overall, participants with painful CIPN reported higher scores across all CIPN severity measures, including behavioral changes. This study underlines the need for accurate identification of different CIPN subgroups in hopes of informing better treatment and rehabilitation options for cancer survivors with painful CIPN.</jats:p>","is_dataset_classified":null,"base_score":2.3978952727983707,"endowment":2.3978952727983707,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38364373","pmcid":null,"openalex_id":"https://openalex.org/W4391875948","authors":[],"funders":[{"funder_name":"National Health and Medical Research Council (NHMRC)","grant_id":"1080521","title":"Long-term Nerve Damage in Cancer Survivors: Identification of Risk Factors and Optimal Assessment Strategies"},{"funder_name":"National Health and Medical Research Council (NHMRC)","grant_id":"1148595","title":"Assessment strategies, Treatments and Risk Factors in Neuropathy and Neuromuscular disease"}],"total_grants":2,"fwci":1.8023,"citation_percentile":0.87095541,"influential_citations":0,"citation_trend":[{"year":2024,"count":2},{"year":2025,"count":6},{"year":2026,"count":2}],"oa_status":"bronze","license":null,"oa_locations":[{"url":"https://jnccn.org/downloadpdf/view/journals/jnccn/22/2/article-p108.pdf","host_type":"journal"},{"url":"https://jnccn.org/downloadpdf/view/journals/jnccn/22/2/article-p108.pdf","host_type":"publisher"},{"url":"https://jnccn.org/view/journals/jnccn/22/2/article-p108.xml","host_type":"publisher"},{"url":"https://jnccn.org/downloadpdf/journals/jnccn/22/2/article-p108.xml","host_type":"publisher"},{"url":"https://doi.org/10.6004/jnccn.2023.7083","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/38364373","host_type":"repository"}],"fields_of_study":["Cancer Treatment and Pharmacology","Cancer-related cognitive impairment studies","Chemotherapy-induced cardiotoxicity and mitigation","03 medical and health sciences","0302 clinical medicine","Humans","Middle Aged","Peripheral Nervous System Diseases","Antineoplastic Agents","Symptom Burden","Quality of Life","Pain","Neoplasms"],"mesh_terms":["Symptom Burden","Antineoplastic Agents","Humans","Middle Aged","Neoplasms","Pain","Peripheral Nervous System Diseases","Quality of Life"],"keywords":["Medicine","Chemotherapy-induced peripheral neuropathy","Physical therapy","Quality of life (healthcare)","Internal medicine","Peripheral neuropathy","Symptom Burden","Neoplasms","Quality of Life","Humans","Peripheral Nervous System Diseases","Pain","Antineoplastic Agents","Middle Aged"],"sdg_mappings":[{"sdg_number":3,"sdg_label":"3. 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