Impact of Chemotherapy-induced Peripheral Neuropathy on Anxiety, Depression, and Quality of Life in Patients with Gastrointestinal Cancer

Objectives: Chemotherapy-induced peripheral neuropathy (CIPN) is a clinically important toxicity that can limit treatment and adversely affect patient well-being.Previous studies on CIPN placed less emphasis on patient-centered outcomes.This study investigated whether the development of CIPN is associated with longitudinal changes of anxiety, depression, and healthrelated quality of life (QOL) in patients with gastrointestinal (GI) cancer.Methods: This secondary analysis used data from a prospective cohort of 55 patients with GI cancer undergoing neurotoxic chemotherapy.Participants were assessed at baseline and at 6 and 12 weeks using the Hospital Anxiety and Depression Scale, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30, and EORTC Quality of Life Questionnaire-CIPN20. Patients were categorized into CIPN (n = 39) and non-CIPN (n = 16) groups based on clinical assessment at 12 weeks.Results: At 12 weeks, the CIPN group reported significantly higher depression scores (9.31 ± 4.02 vs. 5.88 ± 4.51, P = 0.008) and poorer physical functioning (75.56 ± 18.94 vs. 93.33 ± 14.61, P < 0.001) than the non-CIPN group.Repeated-measures analysis showed significant group-by-time interactions for depression (P < 0.001), physical functioning (P < 0.001), and fatigue (P = 0.001), with the CIPN group showing progressive deterioration beginning at week 6.Sensory, motor, and autonomic symptom scores also increased sharply in the CIPN group (all P ≤ 0.001). Conclusion:The occurrence of CIPN is associated with adverse longitudinal changes in depressive symptoms, physical function, and fatigue.These results suggest the need for early multidimensional monitoring and integrated symptom management strategies to preserve the psychological and functional wellbeing in patients with GI cancer.