Article

Over 230,000 new cases of breast cancer are expected to be diagnosed in the
United States in 2015. Taxane-based chemotherapy is often an effective treatment,
but can also cause adverse symptoms in patients due to neurotoxicity. These side
effects can impair postural control in patients; however,
this instability has
scarcely been quantified.
The purpose of this pilot study was to gain insight
into the natural history of postural instability in breast cancer patients being
treated with taxane-based chemotherapy. Thirty-two breast cancer patients (31
female/1 male; 47.6+/-11.2 year; 16 stage II/16 stage III) completed eyes open
and eyes closed quiet standing trials in the oncology clinic where they were
being treated. These trials were collected at five timepoints throughout their
chemotherapy treatment: (1) before initiating chemotherapy to provide a baseline,
(2-4) before starting subsequent chemotherapy cycles, and (5) 1-3 months after
receiving their last taxane infusion. After the first chemotherapy cycle,
patients demonstrated increases in 95% confidence ellipse area of center of
pressure (CoP) [45.2%, p=0.01] and root mean squared CoP excursion [18%, p=0.006]
compared to baseline values for the eyes closed condition. These balance
deficiencies progressed with cumulative taxane exposure. Postural instability
persisted 1-3 months after completing chemotherapy with increases in 95% CoP
ellipse area [86.8%, p=0.002], root mean squared CoP excursion [32.6%, p=0.001],
and mean CoP velocity [30.4%, p=0.024]. The balance impairments demonstrated by
patients in this study appear to be clinically relevant when compared to balance
impairments previously reported in other patient populations.
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