Best of Best Poster Oral Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Does physical activity participation associate with the degree of chemotherapy-induced peripheral neuropathy after neurotoxic treatment? (#336)

David Mizrahi 1 , Terry Trinh 1 , Kimberley Au 1 , Hannah C Timmins 2 , Tiffany Li 2 , J Matt McCrary 1 , Michael Friedlander 3 , Peter Grimison 4 , Susanna B Park 2 , David Goldstein 1
  1. Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
  2. Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
  3. Medical Oncology, Prince of Wales Hospital, Sydney, NSW, Australia
  4. Medical Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting and debilitating side-effect from several chemotherapeutic agents. Little conclusive evidence exists regarding prevention or rehabilitation strategies for CIPN symptoms, however physical activity is increasingly prescribed in oncology clinics to manage treatment side-effects. The aim of this study was to investigate associations between physical activity and CIPN.

 

Methods: Participants with who received neurotoxic chemotherapy for any cancer diagnosis were recruited cross-sectionally post-treatment from 5 Sydney hospitals. CIPN was assessed using objective (Total Neuropathy Score-clinical; TNSc, and Grooved Pegboard Test) and patient-reported (EORTC-CIPN20) methods. Physical activity were assessed using IPAQ-SF, categorised into ‘high’ and ‘low’ levels. Pearson’s correlations and independent samples t-tests were used to determine associations and compared ‘high’ versus ‘low’ physical activity, respectively.

 

Results: 146 participants were recruited (mean=11.3±8.3 months post-treatment, age=58±12, 69% female). The main cancer types were breast (40%) and colorectal (16%), whilst the most common neurotoxic chemotherapies were paclitaxel (45%) and oxaliplatin (18%). 61% experienced neuropathy symptoms at the time of assessment. According to IPAQ-SF, 23% of participants were categorised with ‘low’ and 37% ‘high’ physical activity levels. Participants with ‘high’ physical activity levels demonstrated lower objective CIPN burden than the ‘low’ category (TNSc=3.4±2.7 vs. 4.6±3.1, 95%CI=-0.8-2.3, p=0.036), although displayed no differences in subjective CIPN (total EORTC-CIPN20). Higher physical activity associated with enhanced fine motor function (reduced pegboard time; r=-0.21, p=0.005) and reduced ‘difficulty climbing stairs due to leg weakness’ (EORTC-CIPN20; r=-0.23, p=0.002). Increased weekly walking (minutes) associated with reduced TNSc (r=-0.166, p=0.024) and ‘decreased difficulty walking’ (EORTC-CIPN20; r=0.18, p=0.014).

 

Conclusion: Higher weekly physical activity associated with reduced CIPN symptoms and improved fine-motor skills. Increased walking in particular demonstrated benefits. Studies evaluating the impact of prospective exercise that emphasise walking are warranted to determine their efficacy for patients exposed to neurotoxic chemotherapies in both preventive and rehabilitative applications.