Natural history of paclitaxel-associated acute pain syndrome: prospective cohort study NCCTG N08C1

J Clin Oncol. 2011 Apr 10;29(11):1472-8. doi: 10.1200/JCO.2010.33.0308. Epub 2011 Mar 7.

Abstract

Purpose: The characteristics and natural history of the paclitaxel-acute pain syndrome (P-APS) and paclitaxel's more chronic neuropathy have not been well delineated.

Methods: Patients receiving weekly paclitaxel (70 to 90 mg/m(2)) completed daily questionnaires and weekly European Organisation for Research and Treatment of Cancer (EORTC) Chemotherapy-Induced Peripheral Neuropathy (CIPN) -20 instruments during the entire course of therapy.

Results: P-APS symptoms peaked 3 days after chemotherapy. Twenty percent of patients had pain scores of 5 to 10 of 10 with the first dose of paclitaxel. Sensory neuropathy symptoms were more prominent than were motor or autonomic neuropathy symptoms. Of the sensory neuropathy symptoms, numbness and tingling were more prominent than was shooting or burning pain. Patients with higher P-APS pain scores with the first dose of paclitaxel appeared to have more chronic neuropathy.

Conclusion: These data support that the P-APS is related to nerve pathology as opposed to being arthralgias and/or myalgias. Numbness and tingling are more prominent chronic neuropathic symptoms than is shooting or burning pain.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Disease
  • Antineoplastic Agents, Phytogenic / adverse effects*
  • Area Under Curve
  • Chi-Square Distribution
  • Female
  • Humans
  • Middle Aged
  • Paclitaxel / adverse effects*
  • Pain / chemically induced*
  • Pain Measurement
  • Peripheral Nervous System Diseases / chemically induced*
  • Prospective Studies
  • Statistics, Nonparametric
  • Surveys and Questionnaires
  • Syndrome

Substances

  • Antineoplastic Agents, Phytogenic
  • Paclitaxel