Occurrence and Severity of Chemotherapy-Induced Peripheral Neuropathy and Its Association with Comorbidities in Patients Receiving Cytotoxic Chemotherapy: A Prospective Observational Study

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and dose-limiting adverse effect of cytotoxic chemotherapy that can significantly impair quality of life (QoL), compromise functional status, and affect treatment adherence. Early recognition is essential to improve patient outcomes. Objectives: To evaluate the occurrence and severity of CIPN using clinician-based NCI-CTCAE grading and patient-reported FACT/GOG-Ntx scores, and to identify associated risk factors, including  co morbidity burden. Methods: In this prospective observational study, 200 patients receiving cytotoxic chemotherapy were assessed for CIPN using NCI-CTCAE version 5.0, the FACT/GOG-Ntx questionnaire, and the Charlson Comorbidity Index. Results: CIPN was observed in 124 (62.0%) patients. According to NCI-CTCAE grading, 73 (36.5%) patients had grade 1 neuropathy, 44 (22.0%) had grade 2 neuropathy, and 7 (3.5%) had grade 3 neuropathy. The prevalence increased with age, reaching 13 (81.3%) patients in the 74–83-year age group, and was higher among females. A cumulative effect of chemotherapy was observed with increasing treatment cycles. Platinum-based agents, taxanes, and proteasome inhibitors were most commonly associated with CIPN. Quality of life was adversely affected in 144 (72.0%) patients. CTCAE grading showed a significant association with FACT/GOG-Ntx scores (p < 0.001), although agreement between the assessment tools was low (κ = 0.025). Conclusion: CIPN is a common and clinically relevant toxicity influenced by cumulative chemotherapy exposure, neurotoxic drug class, and increasing age. Combining clinician-based toxicity grading with patient-reported outcome measures may improve early detection, comprehensive assessment, and management of CIPN while supporting treatment continuation and improving quality of life.