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Medline ® Abstract for Reference 65

of 'Overview of neurologic complications of non-platinum cancer chemotherapy'

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BMI, Lifestyle Factors and Taxane-Induced Neuropathy in Breast Cancer Patients: The Pathways Study.
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Greenlee H, Hershman DL, Shi Z, Kwan ML, Ergas IJ, Roh JM, Kushi LH
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J Natl Cancer Inst. 2017;109(2) Epub 2016 Oct 28.
 
BACKGROUND: Lifestyle factors may be associated with chemotherapy-induced peripheral neuropathy (CIPN). We examined associations between body mass index (BMI) and lifestyle factors with CIPN in the Pathways Study, a prospective cohort of women with invasive breast cancer.
METHODS: Analyses included 1237 women who received taxane treatment and provided data on neurotoxicity symptoms. Baseline interviews assessed BMI (normal:<25 kg/m(2); overweight: 25-29.9 kg/m(2); obese:≥30 kg/m(2)), moderate-to-vigorous physical activity (MVPA) (low:<2.5; medium: 2.5-5; high:>5 hours/week) and fruit/vegetable intake (low:<35 servings/week; high:≥35 servings/week). Baseline and six-month interviews assessed antioxidant supplement use (nonuser, discontinued, continued user, initiator). CIPN was assessed at baseline, six months, and 24 months using the Functional Assessment of Cancer Therapy-Taxane Neurotoxicity (FACT-NTX); a 10% decrease was considered clinically meaningful.
RESULTS: At baseline, 65.6% of patients in the sample were overweight or obese, 29.9% had low MVPA, 57.5% had low fruit/vegetable intake, and 9.5% reported antioxidant supplement use during treatment. In multivariable analyses, increased CIPN was more likely to occur in overweight (odds ratio [OR]= 2.37, 95% confidence interval [CI]= 1.19 to 4.88) and obese patients (OR = 3.21, 95% CI = 1.52 to 7.02) compared with normal weight patients at 24 months and less likely to occur in patients with high MVPA compared with those with low MVPA at six (OR = 0.56, 95% CI = 0.34 to 0.94) and 24 months (OR = 0.43, 95% CI = 0.21 to 0.87). Compared with nonusers, patients who initiated antioxidant use during treatment were more likely to report increased CIPN at six months (OR = 3.81, 95% CI = 1.82 to 8.04).
CONCLUSIONS: Obesity and low MVPA were associated with CIPN in breast cancer patients who received taxane treatment.
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Mailman School of Public Health (HG, DLH, ZS), Herbert Irving Comprehensive Cancer Center (HG, DLH), and College of Physicians and Surgeons (DLH), Columbia University, New York, NY; Division of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, IJE, JMR, LHK). hg2120@columbia.edu.
PMID