Impact of chemotherapy-induced neurotoxicities on adult cancer survivors' symptom burden and quality of life

J Cancer Surviv. 2018 Apr;12(2):234-245. doi: 10.1007/s11764-017-0662-8. Epub 2017 Nov 20.


Purpose: Limited information is available on the impact of chemotherapy (CTX)-induced neurotoxicity on adult survivors' symptom experience and quality of life (QOL). Purposes were to describe occurrence of hearing loss and tinnitus and evaluate for differences in phenotypic characteristics and measures of sensation, balance, perceived stress, symptom burden, and QOL between survivors who received neurotoxic CTX and did (i.e., neurotoxicity group) and did not (i.e., no neurotoxicity group) develop neurotoxicity. Neurotoxicity was defined as the presence of chemotherapy-induced neuropathy (CIN), hearing loss, and tinnitus. Survivors in the no neurotoxicity group had none of these conditions.

Methods: Survivors (n = 609) completed questionnaires that evaluated hearing loss, tinnitus, stress, symptoms, and QOL. Objective measures of sensation and balance were evaluated.

Results: Of the 609 survivors evaluated, 68.6% did and 31.4% did not have CIN. Of the survivors without CIN, 42.4% reported either hearing loss and/or tinnitus and 48.1% of the survivors with CIN reported some form of ototoxicity. Compared to the no neurotoxicity group (n = 110), survivors in the neurotoxicity group (n = 85) were older, were less likely to be employed, had a higher comorbidity burden, and a higher symptom burden, higher levels of perceived stress, and poorer QOL (all p < .05).

Conclusions: Findings suggest that CIN, hearing loss, and tinnitus are relatively common conditions in survivors who received neurotoxic CTX.

Implications for cancer survivors: Survivors need to be evaluated for these neurotoxicities and receive appropriate interventions. Referrals to audiologists and physical therapists are warranted to improve survivors' hearing ability, functional status, and QOL.

Keywords: Balance; Chemotherapy; Hearing loss; Peripheral neuropathy; Survivor; Tinnitus.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Cancer Survivors / psychology*
  • Cancer Survivors / statistics & numerical data*
  • Comorbidity
  • Cost of Illness*
  • Employment / psychology
  • Employment / statistics & numerical data
  • Female
  • Hearing Loss / chemically induced
  • Hearing Loss / epidemiology
  • Hearing Loss / psychology
  • Humans
  • Male
  • Middle Aged
  • Neurotoxicity Syndromes* / complications
  • Neurotoxicity Syndromes* / epidemiology
  • Neurotoxicity Syndromes* / psychology
  • Peripheral Nervous System Diseases* / chemically induced
  • Peripheral Nervous System Diseases* / complications
  • Peripheral Nervous System Diseases* / epidemiology
  • Peripheral Nervous System Diseases* / psychology
  • Postural Balance / drug effects
  • Quality of Life*
  • Sensation Disorders / chemically induced
  • Sensation Disorders / epidemiology
  • Sensation Disorders / psychology
  • Surveys and Questionnaires
  • Tinnitus / chemically induced
  • Tinnitus / epidemiology
  • Tinnitus / psychology