Prevalence and predictors for cisplatin-induced toxicities in Zimbabwean women with cervical cancer

<b>Aim:</b> To describe treatment-induced toxicities (TITs) and associated factors in Zimbabwean cancer patients receiving cisplatin. <b>Methods:</b> In total, 252 Zimbabwean women with cervical cancer, receiving cisplatin were followed up over 12 months for TITs and disease status. <b>Results:</b> Peripheral neuropathy (70%) and ototoxicity (53%) were most prevalent. Advanced disease (OR = 1.3; 95% CI = 1.1–1.5; p = 0.02), pain comedications (OR = 1.3; 95% CI = 1.1–1.5; p = 0.03), alcohol (OR = 2.8; 95% CI = 1.1–7.5; p = 0.04) and comorbidities (OR = 1.2; 95% CI = 1.1–1.4; p = 0.04) increased peripheral neuropathy and ototoxicity risk. Older age increased risk of disease progression (OR = 1.9; 95% CI = 1.4–3.0; p = 0.033). <b>Conclusion:</b> High peripheral neuropathy and ototoxicity prevalence were observed, which are not routinely monitored in Zimbabwe. There is a need for capacity building to incorporate comprehensive TIT testing and optimize cancer care in Zimbabwe. Cancer treatment has side effects, also known as treatment-induced toxicities (TITs), that can lead to death if not management properly. African populations are more likely to develop TITs, however, not many studies research on TITs in Africans and why they are more prone to TITs. This study followed up 252 Zimbabwean women with cervical cancer, over 12 months for TITs and found that loss of sensation and ear complications most commonly occurred after treatment. Advanced disease, prescribed pain medication, alcohol consumption history and underlying diseases such as diabetes increased likelihood of TITs, while older age increased risk of unresponsive cancer. This study highlights a need to incorporate comprehensive monitoring for TITs for at-risk individuals toward improving cancer care. Peripheral neuropathy and ototoxicity are common in Zimbabwean cancer patients, even though they are not routinely monitored in oncology facilities. Clinical factors such as comorbid conditions, pain co-medications and high cisplatin dose increase the risk of developing treatment-induced toxicities (TITs). High BMI was a predictor of peripheral neuropathy development. Lifestyle factors such as history of alcohol consumption can increase the risk of treatment-induced toxicities. In this study, HIV was not a risk factor for any of the TITs and treatment outcomes such as relapse, disease progression and mortality. Older patients are more prone to poor prognosis compared with younger patients highlighting a need for cancer screening even beyond the prescribed age of 40 years. Comprehensive TIT monitoring should be implemented in Zimbabwe primary care for cancer patients, to include peripheral neuropathy and ototoxicity, toward improving patient management. More studies to describe TITs in low-resource settings such as Zimbabwe are required in order to personalize medicine.