Assessment of Pediatric Chemotherapy-Induced Peripheral Neuropathy Using a New Patient-Reported Outcome Measure: The P-CIN

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is commonly experienced by children receiving neurotoxic chemotherapy. No validated pediatric CIPN patient-reported outcome (PRO) measures exist. Purpose: To test sensitivity, internal consistency reliability, content and convergent validity, and feasibility of the Pediatric Chemotherapy-Induced Neuropathy (P-CIN), an electronic PRO measure for assessing CIPN in children who received neurotoxic chemotherapy. Method: Five experts evaluated content validity of the 14-item P-CIN. Children 5 to 17 years old with CIPN ( N = 79) completed the P-CIN via tablet computer; a subset ( n = 26) also underwent neurological examinations using the Pediatric–Modified Total Neuropathy Score. Following preliminary analyses, one item was deleted and three others modified. The revised P-CIN was retested with patients ( n = 6) who also completed the Bruininks–Oseretsky Test of Motor Proficiency motor function assessment. Means, item response ranges, standard deviations, content validity indexes, Cronbach’s alphas, and correlation coefficients were calculated. Results: Mean participant age was 11.25 ( SD = 4.0) years. Most had acute leukemia (62.5%) and received vincristine (98.7%). Content validity index coefficients ranged from .80 to 1.0 ( p = .05). For 9 of 14 items, responses ranged from 0 to 4 or 5; response ranges for toe numbness, pick up a coin, and three of four pain items were 0 to 3. After deleting one item, Cronbach’s alpha coefficient was .83. P-CIN scores were strongly associated with Pediatric-Modified Total Neuropathy Score ( r = .52, p < .01) and Bruininks–Oseretsky Test of Motor Proficiency ( r = −.83, p = .04) scores. Sixty-eight percent of children 6 to 17 years old completed P-CIN independently. Discussion: Preliminary evidence suggests that the 13-item P-CIN is internally consistent, is valid, and can be completed independently by children ≥ 6 years. However, we recommend additional testing.

Examination of the psychometric properties of pediatric-modified total neuropathy score in Turkish children with cancer

“…The Pediatric-Modi ed Total Neuropathy Score (ped-mTNS) was adapted from the original TNS scale to be used in oncology clinics to determine CIPN and its severity in children receiving cancer treatment, and its validity and reliability study was conducted [6,13]. For health professionals to better manage the symptoms of children receiving chemotherapy, assessment tools that they can apply or that are reported by the patient should be developed [14,15]. Recognition and early detection of peripheral neuropathies, which are known as side effects of chemotherapy agents, are important for nurses working in oncology services.…”

Kanser Tedavisi Alan Çocuklarda Kemoterapiyle İlişkili Periferik Nöropatinin Değerlendirilmesinde Hemşirenin Rolü

“…Hemşireler KİPN belirti ve bulgularını ebeveyne ve çocuğa anlatmalıdır ayrıca ölçüm araçlarından faydalanarak klinik semptomlar takip edilmelidir. Çocuğa ellerinde ve ayaklarında karıncalanma, sıcak-soğuk duyarlılığı olup olmadığı sözel alarak sorularak duyusal semptom varlığı değerlendirilmelidir (36,41).…”

“…Pediatrik kemoterapiyle ilişkili periferik nöropati (P-CIN) ölçümü, pediatrik hematoloji ve onkoloji klinik servislerinde altı yaşından büyük çocuklar tarafından kullanılmak için uygun ve VİPN'yi ölçmek için geçerli olarak bulunmuştur. KİPN değerlendirmesinin zorluğuna rağmen, yeni P-CIN ölçümü, KİPN'yi eğitimli değerlendiricilere ihtiyaç duymadan doğrudan çocuklardan alınan verilerle değerlendirme ve izleme potansiyeli göstermiştir (41). Kanser tanılı pediatrik popülasyonda KİPN'yi değerlendirme araçları Şekil 1'de verilmiştir.…”

“…Egzersiz müdahalesinin subjektif KİPN semptomlarını hafifletmede etkili olmadığı, ancak kas gücünü, dayanıklılığını ve yaşam kalitesini iyileştirmede etkili olduğu saptanmıştır (47). Şu anda bilinen hiçbir tedavi çocuklarda KİPN'i etkili bir şekilde azaltamamaktadır(41).…”

Multi-responsive chitosan-based hydrogels for controlled release of vincristine

“…It is a highly effective chemotherapeutic agent currently being used to treat acute lymphocytic leukemia, ‘Hodgkin’s and non-lymphoma, and solid tumors such as sarcomas, neuroblastoma and breast cancer 8 . However, its therapeutic applications are limited due to neurotoxicity and other potential side effects 9 . VCR interacts with and triggers apoptosis in tubulin-expressing cells 10 .…”