• Christine Miaskowski, Steven M Paul, Judy Mastick, Gary Abrams, Kimberly Topp, Betty Smoot, Kord M Kober, Margaret Chesney, Melissa Mazor, Grace Mausisa, Mark Schumacher, Yvette P Conley, Jennifer Henderson Sabes, Steven Cheung, Margaret Wallhagen, and Jon D Levine.
• School of Nursing, University of California, San Francisco, California, USA. Electronic address: chris.miaskowski@ucsf.edu.
• J Pain Symptom Manage. 2018 Jul 1; 56 (1): 889788-97.

ContextThe most common adverse effects from neurotoxic chemotherapy are chemotherapy-induced neuropathy (CIPN), hearing loss, and tinnitus. Although associations between perceived stress and persistent pain, hearing loss, and tinnitus are documented, no studies have examined these associations in cancer survivors who received neurotoxic chemotherapy.ObjectivesIn this cross-sectional study, we evaluated for associations between perceived stress and the occurrence of CIPN, hearing loss, and tinnitus, in 623 adult cancer survivors who received platinum and/or taxane compounds.MethodsSurvivors completed self-report measures of hearing loss, tinnitus, and perceived stress (i.e., Impact of Events Scale-Revised [IES-R]). Separate logistic regression analyses were done for each neurotoxicity to evaluate whether each of the IES-R subscale (i.e., intrusion, avoidance, hyperarousal) and total scores made a significant independent contribution to neurotoxicity group membership.ResultsOf the 623 survivors in this study, 68.4% had CIPN, 34.5% reported hearing loss, and 31.0% reported tinnitus. Older age, higher body mass index, poorer functional status, being born prematurely, cancer diagnosis, and higher intrusion (P = 0.013), hyperarousal (P = 0.014), and total (P = 0.047) IES-R scores were associated with CIPN. Older age, being male, poorer functional status, a worse comorbidity profile, and a higher IES-R hyperarousal (P = 0.007) score were associated with hearing loss. Being male, having less education, a worse comorbidity profile, and a higher IES-R hyperarousal (P = 0.029) score were associated with tinnitus.ConclusionThese findings suggest that increased levels of perceived stress are associated with the most common chemotherapy-induced neurotoxicities.Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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