Chronic chemotherapy-induced peripheral neuropathy and pain following paclitaxel versus docetaxel in breast cancer survivors: A cross-sectional study

Chemotherapy-induced peripheral neuropathy (CIPN) is a concerning late effect of taxane treatment. This study aimed to explore and compare long-term symptoms and consequences of CIPN after docetaxel and paclitaxel treatment. Patients with breast cancer who had followed Danish recommended adjuvant docetaxel or paclitaxel treatment regimens completed an online questionnaire 2-3 years after treatment. The questionnaire comprised the Michigan Neuropathy Screen Instrument, the European Organization for Research and Treatment of Cancer (EORTC) QLQ-CIPN20, EORTC QLQ C30, and CIPN-specific symptoms. Painful CIPN was assessed using the Douleur Neuropathique 4 Questions. Questionnaires from 411 patients (docetaxel: 192, paclitaxel: 219) were analyzed. No significant difference in the prevalence of possible CIPN between the two groups was observed (docetaxel: 48.4 % [93/192] vs. paclitaxel: 45.2 % [99/219]; 95 % CI: 6.4 - 12.9, p = 0.51). However, the EORTC-QLQ-CIPN20 sum score was higher in the docetaxel group (difference: 3.0; 95 % CI: 0.0-6.1, p = 0.05). Among patients with reported CIPN symptoms, significantly more in the docetaxel group reported painful CIPN (docetaxel: 53.8 % [50/93] than in the paclitaxel group: 34.3 % [34/99]; p = 0.01). Quality of life scores from the EORCT-QLQ-C30 questionnaire were significantly lower in those with possible CIPN than in those without and lower in patients with painful possible CIPN than in those with painless CIPN. Docetaxel caused more severe and painful CIPN symptoms than paclitaxel. These findings are highly relevant, as docetaxel remains a crucial component of cancer treatments.