Gender and age effects on the incidence and severity of chemotherapy-induced neuropathic pain: a propensity score matching analysis

Abstract Objective To determine whether the clinical phenotype of chemotherapy-induced neuropathic pain (CINP) varies based on the gender and age of patients. Methods Retrospective, file-based analysis of cancer patients who received any conventional standard of care chemotherapy and were referred t...

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Main Authors: Andreas A. Argyriou, Roser Velasco, Foteini Kalofonou, Pantelis Litsardopoulos, Montse Alemany, Dimitrios Rikos, Haralabos P. Kalofonos, Jordi Bruna
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14579-x
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author Andreas A. Argyriou
Roser Velasco
Foteini Kalofonou
Pantelis Litsardopoulos
Montse Alemany
Dimitrios Rikos
Haralabos P. Kalofonos
Jordi Bruna
author_facet Andreas A. Argyriou
Roser Velasco
Foteini Kalofonou
Pantelis Litsardopoulos
Montse Alemany
Dimitrios Rikos
Haralabos P. Kalofonos
Jordi Bruna
author_sort Andreas A. Argyriou
collection DOAJ
description Abstract Objective To determine whether the clinical phenotype of chemotherapy-induced neuropathic pain (CINP) varies based on the gender and age of patients. Methods Retrospective, file-based analysis of cancer patients who received any conventional standard of care chemotherapy and were referred to assess the extent of painful chemotherapy-induced peripheral neurotoxicity (CIPN). A Propensity Score Matching Analysis (PSMA) was conducted to create balanced cohorts; accounting for variables that could impact the incidence and severity of CINP in CIPN patients. A total of 205 males and 295 females were initially included, and after PSMA, 191 patients of each gender were equally matched; totaling 382 patients. These patients were divided according to their age to those aged ≤65 years (group I, n=216) and patients aged ≥66 years (group II, n=166). CINP was assessed using the pain intensity numerical rating scale (PI-NRS) and the Douleur Neuropathique-4 questionnaire (DN4). The severity of CIPN was graded with Total Neuropathy Score-clinical (TNSc®). Results The incidence of CINP was similar between males and females (27.2% vs. 27.7%; p = 1). The same applied for the DN4 scorings at CINP onset (median 7; p = 0.9). The severity of CINP at the end of chemotherapy, according to PI-NRS, was 7 (range:6–9) for males vs. 7 (range: 5–8) for females (p = 0.09), while at 3 months post-chemotherapy the PI-NRS scorings were comparable (p = 0.56). However, males tended towards higher rates of severe CINP (PI-NRS ≥ 7) [males: 59.5%, females: 40.5%; p = 0.1], compared to female patients, despite having lower CIPN severities, according to TNSc® scoring. No statistically significant differences were observed in the incidence (25% vs. 30.7%; p = 0.214) and severity (mean PI-NRS difference p = 0.584) of CINP between age groups. Older male patients presented a higher likelihood (OR: 1.08; 95CI: 1.01–1.16; p = 0.027) of severe pain (PI-NRS ≥ 7) at the end of chemotherapy, compared to their younger counterparts. Conclusion There were no significant differences found between the occurrence and severity of CINP, based on gender or age. However, older men had more severe pain raters (PI-NRS), while scoring lower in TNSc® severities.
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spelling doaj-art-5ff0c2458bea473c91bfde56f3df2e4d2025-08-20T04:02:55ZengBMCBMC Cancer1471-24072025-07-012511710.1186/s12885-025-14579-xGender and age effects on the incidence and severity of chemotherapy-induced neuropathic pain: a propensity score matching analysisAndreas A. Argyriou0Roser Velasco1Foteini Kalofonou2Pantelis Litsardopoulos3Montse Alemany4Dimitrios Rikos5Haralabos P. Kalofonos6Jordi Bruna7Neurological Department, “Agios Andreas” General Hospital of PatrasHospital UnivNeuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO L’Hospitalet, IDIBELLersitari de Bellvitge-ICO L’Hospitalet, IDIBELLDepartment of Oncology, The Royal Marsden Hospital NHS TrustNeurological Department, “Agios Andreas” General Hospital of PatrasHospital UnivNeuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO L’Hospitalet, IDIBELLersitari de Bellvitge-ICO L’Hospitalet, IDIBELLDepartment of Neurology, 404 Military Hospital of LarissaDepartment of Medicine, Division of Oncology, University Hospital of PatrasHospital UnivNeuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO L’Hospitalet, IDIBELLersitari de Bellvitge-ICO L’Hospitalet, IDIBELLAbstract Objective To determine whether the clinical phenotype of chemotherapy-induced neuropathic pain (CINP) varies based on the gender and age of patients. Methods Retrospective, file-based analysis of cancer patients who received any conventional standard of care chemotherapy and were referred to assess the extent of painful chemotherapy-induced peripheral neurotoxicity (CIPN). A Propensity Score Matching Analysis (PSMA) was conducted to create balanced cohorts; accounting for variables that could impact the incidence and severity of CINP in CIPN patients. A total of 205 males and 295 females were initially included, and after PSMA, 191 patients of each gender were equally matched; totaling 382 patients. These patients were divided according to their age to those aged ≤65 years (group I, n=216) and patients aged ≥66 years (group II, n=166). CINP was assessed using the pain intensity numerical rating scale (PI-NRS) and the Douleur Neuropathique-4 questionnaire (DN4). The severity of CIPN was graded with Total Neuropathy Score-clinical (TNSc®). Results The incidence of CINP was similar between males and females (27.2% vs. 27.7%; p = 1). The same applied for the DN4 scorings at CINP onset (median 7; p = 0.9). The severity of CINP at the end of chemotherapy, according to PI-NRS, was 7 (range:6–9) for males vs. 7 (range: 5–8) for females (p = 0.09), while at 3 months post-chemotherapy the PI-NRS scorings were comparable (p = 0.56). However, males tended towards higher rates of severe CINP (PI-NRS ≥ 7) [males: 59.5%, females: 40.5%; p = 0.1], compared to female patients, despite having lower CIPN severities, according to TNSc® scoring. No statistically significant differences were observed in the incidence (25% vs. 30.7%; p = 0.214) and severity (mean PI-NRS difference p = 0.584) of CINP between age groups. Older male patients presented a higher likelihood (OR: 1.08; 95CI: 1.01–1.16; p = 0.027) of severe pain (PI-NRS ≥ 7) at the end of chemotherapy, compared to their younger counterparts. Conclusion There were no significant differences found between the occurrence and severity of CINP, based on gender or age. However, older men had more severe pain raters (PI-NRS), while scoring lower in TNSc® severities.https://doi.org/10.1186/s12885-025-14579-xChemotherapy-induced peripheral neurotoxicityChemotherapy-induced neuropathic painGenderAgeRisk factors
spellingShingle Andreas A. Argyriou
Roser Velasco
Foteini Kalofonou
Pantelis Litsardopoulos
Montse Alemany
Dimitrios Rikos
Haralabos P. Kalofonos
Jordi Bruna
Gender and age effects on the incidence and severity of chemotherapy-induced neuropathic pain: a propensity score matching analysis
BMC Cancer
Chemotherapy-induced peripheral neurotoxicity
Chemotherapy-induced neuropathic pain
Gender
Age
Risk factors
title Gender and age effects on the incidence and severity of chemotherapy-induced neuropathic pain: a propensity score matching analysis
title_full Gender and age effects on the incidence and severity of chemotherapy-induced neuropathic pain: a propensity score matching analysis
title_fullStr Gender and age effects on the incidence and severity of chemotherapy-induced neuropathic pain: a propensity score matching analysis
title_full_unstemmed Gender and age effects on the incidence and severity of chemotherapy-induced neuropathic pain: a propensity score matching analysis
title_short Gender and age effects on the incidence and severity of chemotherapy-induced neuropathic pain: a propensity score matching analysis
title_sort gender and age effects on the incidence and severity of chemotherapy induced neuropathic pain a propensity score matching analysis
topic Chemotherapy-induced peripheral neurotoxicity
Chemotherapy-induced neuropathic pain
Gender
Age
Risk factors
url https://doi.org/10.1186/s12885-025-14579-x
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