Pitfalls in grading severity of chemotherapy-induced peripheral neuropathy

Postma, Tjeerd J.; Heimans, Jan J.; Müller, Martin; Ossenkoppele, GJ; Vermorken, Jan B.; Aaronson, Neil K.

doi:10.1023/a:1008344507482

Cited by 185 publications

(142 citation statements)

References 16 publications

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“…However, in our study the NCI-CTC reliability scores were higher than previously reported [10]. This difference is likely to be due to the different experimental approach and to the larger sample size analyzed in our study.…”

Section: Discussioncontrasting

confidence: 90%

“…This difference is likely to be due to the different experimental approach and to the larger sample size analyzed in our study. In fact, in the study by Postma et al [10] only 37 patients were evaluated and 'interpretation of the scales was left to the judgment of the observers and the mode of neurological history-taking and neurological examination was deliberately left unstandardized'. It is conceivable that the high reliability scores in the current study are attributed to the consensus achieved on how to score the various components of the different scales including the NCI-CTC.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, most of these measures have not been rigorously evaluated in terms of their scientific clinimetric soundness before their use [4]. As such, it is not surprising that 'poor to fair' to 'substantial' reliability scores have been reported for various outcome measures in CIPN [10,15].…”

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confidence: 99%

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The chemotherapy-induced peripheral neuropathy outcome measures standardization study: from consensus to the first validity and reliability findings

Cavaletti¹,

Cornblath²,

Merkies³

et al. 2013

Annals of Oncology

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Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and dose-limiting complication of cancer treatment. Thus far, the impact of CIPN has not been studied in a systematic clinimetric manner. The objective of the study was to select outcome measures for CIPN evaluation and to establish their validity and reproducibility in a cross-sectional multicenter study. Patients and methods:After literature review and a consensus meeting among experts, face/content validity were obtained for the following selected scales: the National Cancer Institute-Common Toxicity Criteria (NCI-CTC), the Total Neuropathy Score clinical version (TNSc), the modified Inflammatory Neuropathy Cause and Treatment (INCAT) group sensory sumscore (mISS), the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, and CIPN20 quality-of-life measures. A total of 281 patients with stable CIPN were examined. Validity (correlation) and reliability studies were carried out.Results: Good inter-/intra-observer scores were obtained for the TNSc, mISS, and NCI-CTC sensory/motor subscales. Test-retest values were also good for the EORTC QLQ-C30 and CIPN20. Acceptable validity scores were obtained through the correlation among the measures. Conclusion:Good validity and reliability scores were demonstrated for the set of selected impairment and quality-of-life outcome measures in CIPN. Future studies are planned to investigate the responsiveness aspects of these measures.

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Section: Discussioncontrasting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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The chemotherapy-induced peripheral neuropathy outcome measures standardization study: from consensus to the first validity and reliability findings

Cavaletti¹,

Cornblath²,

Merkies³

et al. 2013

Annals of Oncology

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256

218

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“…The present study confirms that persistent peripheral neuropathy is a common occurrence following oxaliplatin treatment, with 79.2% of patients with residual neuropathic symptoms at the time of follow-up. Grading of chemotherapy-induced neuropathy is problematic, with the lack of standardization and ambiguity in measurement contributing to underestimation of neuropathy incidence and severity [32,33]. Using clinical grading scales, oxaliplatininduced neuropathy has been characterized as completely reversible within 6 months [3, 5, 31], with the majority of patients experiencing improvement or recovery within 1 month [1,2].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Neuropathy After Oxaliplatin Treatment: Challenging the Dictum of Reversibility

et al. 2011

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After completing this course, the reader will be able to:1. Define the symptoms of sensory neurotoxicity in oxaliplatin-treated patients and identify the long-term natural history of nerve dysfunction as a long-lasting complication of treatment that does not necessarily resolve within 6 months.2. Use sensory excitability techniques to predict long-standing changes in sensory nerve function produced by oxaliplatin.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTObjectives. Oxaliplatin-induced neuropathy is a significant and dose-limiting toxicity that adversely affects quality of life. However, the long-term neurological sequelae have not been adequately described. The present study aimed to describe the natural history of oxaliplatin-induced neuropathy, using subjective and objective assessments. The Oncologist CME Program is located online at http://cme.theoncologist.com/. To take the CME activity related to this article, you must be a registered user. Methods. From a population of 108 oxaliplatin-treated Symptom Management and Supportive CareThe Oncologist 2011;16:708 -716 www.TheOncologist.com Results. At follow-up, 79.2% of patients reported residual neuropathic symptoms, with distal loss of pinprick sensibility in 58.3% of patients and loss of vibration sensibility in 83.3% of patients. Symptom severity scores were significantly correlated with cumulative dose. There was no recovery of sensory action potential amplitudes in upper and lower limbs, consistent with persistent axonal sensory neuropathy. Sensory excitability parameters had not returned to baseline levels, suggesting persisting abnormalities in nerve function. The extent of excitability abnormalities during treatment was significantly correlated with clinical outcomes at follow-up.Conclusions. These findings establish the persistence of subjective and objective deficits in oxaliplatin-treated patients post-oxaliplatin, suggesting that sensory neuropathy is a long-term outcome, thereby challenging the literature on the reversibility of oxaliplatin-induced neuropathy. The Oncologist 2011;16:708 -716

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“…However, these are heavily reliant on the patients subjective reports, and can be insensitive to change [1]. Studies suggest the incidence and sequalae of CIPN are poorly understood [2,3] with more comprehensive investigation required [2,4].…”

Section: Introductionmentioning

confidence: 99%

Chemotherapy induced peripheral neuropathy: the modified total neuropathy score in clinical practice

et al. 2013

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Background: Chemotherapy induced peripheral neuropathy (CIPN) is a common, potentially reversible side-effect of some chemotherapeutic agents. CIPN is associated with decreased balance, function and quality of life (QoL). This association has to date been under-investigated. Aims:To profile patients presenting with CIPN using the modified Total Neuropathy Score (mTNS) in this cross-sectional study. To examine the relationship between CIPN (measured by mTNS) and indices of balance, quality of life (QoL) and function Methods: Patients receiving neurotoxic chemotherapy regimens were identified using hospital databases. Those who did not have a pre-existing neuropathy were invited to complete mTNS, berg balance scale (BBS), timed up and go (TUG), and FACT-G QoL questionnaire. mTNS scores were profiled and also correlated with BBS, TUG and FACT-G using Spearmans correlation coefficient. Results: A total of 29 patients undergoing neurotoxic chemotherapy regimens were tested. The patients mTNS scores ranged between 1 and 12 (median = 5), indicating that all patients had clinical evidence of neuropathy on mTNS. No significant correlations were found between mTNS and BERG (r = -.29), TUG (r = .14), or FACT-G (r = 0.05). Conclusions: This study found a high prevalence of CIPN in patients treated with neurotoxic chemotherapy regimens. The mTNS provided a clinically applicable, sensitive screening tool for CIPN which could prove useful in clinical practice. mTNS did not correlate with BBS, TUG or FACT-G in this sample, possibly due to relatively mild levels of CIPN and consequent subtle impairments which were not adequately captured by gross functional assessments.

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Pitfalls in grading severity of chemotherapy-induced peripheral neuropathy

Cited by 185 publications

References 16 publications

The chemotherapy-induced peripheral neuropathy outcome measures standardization study: from consensus to the first validity and reliability findings

The chemotherapy-induced peripheral neuropathy outcome measures standardization study: from consensus to the first validity and reliability findings

Long-Term Neuropathy After Oxaliplatin Treatment: Challenging the Dictum of Reversibility

Chemotherapy induced peripheral neuropathy: the modified total neuropathy score in clinical practice

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