Phenotypic Characterization of Paclitaxel-Induced Peripheral Neuropathy in Cancer Survivors

J Pain Symptom Manage. 2018 Dec;56(6):908-919.e3. doi: 10.1016/j.jpainsymman.2018.08.017. Epub 2018 Aug 30.


Context: Although paclitaxel is one of the most commonly used drugs to treat breast, ovarian, and lung cancers, little is known about the impact of paclitaxel-induced peripheral neuropathy (PIPN) on cancer survivors.

Objectives: The purposes of this study were to evaluate for differences in demographic and clinical characteristics as well as measures of sensation, balance, upper extremity function, perceived stress, symptom burden, and quality of life (QOL) between survivors who received paclitaxel and did (n = 153) and did not (n = 58) develop PIPN.

Methods: Pain characteristics associated with PIPN are described in detail. Both subjective and objective measures were used to evaluate the impact of PIPN.

Results: Survivors with PIPN were significantly older, had a higher body mass index, and a worse comorbidity profile. The duration of PIPN was almost four years, and pain scores were in the moderate range. Compared with survivors without PIPN, survivors with PIPN had a higher number of upper and lower extremity sites that had lost light touch, cold, and pain sensations. Survivors with PIPN had worse upper extremity function, more problems with balance, a higher symptom burden, and higher levels of perceived stress. In addition, survivors with PIPN had worse QOL scores particularly in the domain of physical functioning.

Conclusion: The findings from this large descriptive study are the first to document the impact of PIPN on survivors' symptom burden, functional status, and QOL.

Keywords: Paclitaxel; balance; cancer; chemotherapy; pain; peripheral neuropathy; quality of life; stress; survivor.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents, Phytogenic / adverse effects*
  • Cancer Survivors* / psychology
  • Cost of Illness
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Paclitaxel / adverse effects*
  • Pain
  • Peripheral Nervous System Diseases / chemically induced*
  • Peripheral Nervous System Diseases / physiopathology
  • Peripheral Nervous System Diseases / psychology
  • Postural Balance
  • Quality of Life
  • Socioeconomic Factors
  • Stress, Psychological


  • Antineoplastic Agents, Phytogenic
  • Paclitaxel