Influencing factors of acute severe to very severe peripheral neuropathy induced by albumin-bound paclitaxel

Paclitaxel is the primary chemotherapy agents for many high-incidence cancers, and they also pose a significant risk for peripheral neuropathy. This study investigated the factors influencing paclitaxel-induced peripheral neuropathy (PIPN). We utilized PRO-CTCAE to assess the incidence of PIPN in patients receiving a tri-weekly regimen of single-agent albumin-bound paclitaxel through an online platform within one week after chemotherapy. Multivariable logistic regression was employed to analyze the impact of personal characteristics, clinical data and chemotherapy dose. All the statistical analyses were conducted in R studio. The incidence of acute severe to very severe PIPN was 36.7%, and the risk factors included per 200 mg increment in cumulative dose (OR 1.13, 95% 1.03 ∼ 1.24), estimated glomerular filtration rate < 90 ml/min/1.73m² (OR 1.72, 95%CI 1.11 ∼ 2.66), anemia (OR 2.60, 95%CI 1.63 ∼ 4.15), albumin ≥ 40g/L (OR 1.74, 95%CI 1.04 ∼ 2.90), female (OR 1.98, 95%CI 1.19 ∼ 3.29), and overweight (OR 1.74, 95%CI 1.04 ∼ 2.91). The incidence of acute severe to very severe peripheral neuropathy caused by albumin-bound paclitaxel is relatively high. Nutritional status, gender, renal function and cumulative dose were all closely related to this incidence rate. Therefore, in the future, it is of great importance that a comprehensive and systematic assessment regarding the individual risks for patients be carried out in a meticulous manner. Relevant research should be conducted into the mechanisms underlying peripheral neuropathy, with particular attention to the role of individual factors.