Quantitative sensory profiles of upper extremity chemotherapy induced peripheral neuropathy: Are there differences in sensory profiles for neuropathic versus nociceptive pain?

Hammond, Elizabeth; Pitz, Marshall; Lambert, Pascal; Shay, Barbara

doi:10.1080/24740527.2019.1665992

Cited by 3 publications

(5 citation statements)

References 48 publications

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“…Interestingly, foot CPT was not associated with CIPN-related DR/PD. In fact, while lower limb disability, balance problems, and falls are associated with CIPN presence and severity 32,34,73,74 , in this study, these factors were not associated with CIPN-related DR/PD. It is possible that sensory abnormalities in the hands have a greater impact on daily life, or are interpreted as such, than sensory abnormalities in the feet, contributing to decision-making.…”

Section: Discussioncontrasting

confidence: 54%

“…Since the guidelines recommend DR/PD discussion for intolerable CIPN 4 , an understanding of biopsychosocial factors associated with CIPN presence or severity may provide insight. CIPN presence and severity are associated with paclitaxel treatment and dose 18 , greater post-treatment depression, anxiety, and insomnia, lower quality of life (QOL) 19–21 and physical wellbeing 3 , balance problems and falls 29,32–34 , and impaired functioning 35,36 . Greater pre-treatment anxiety, depression and fatigue also predict post-treatment CIPN presence and severity 37,38 .…”

Section: Introductionmentioning

confidence: 99%

“…It can track sensory changes throughout treatment 17,18,39 , improve CIPN detection, and guide decision-making 7,40 . For example, cold allodynia and hyperalgesia in the hand predicts severe neuropathy 33 , people with CIPN have lower heat pain threshold than people without CIPN 34 , and moderate-to-severe CIPN is associated with reduced tactile and vibration perception in some studies 26 , but not others 35 . Studies of CIPN-related DR/PD using QST do not exist.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with chemotherapy-induced peripheral neuropathy-related reduced taxane dose or premature discontinuation in women with early-stage breast cancer

Gauthier

Robichaud

Bouffard

et al. 2021

Preprint

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Purpose: In the absence of treatments for chemotherapy-induced peripheral neuropathy (CIPN), dose reductions (DR) and premature discontinuation (PD) are primary management strategies. However, decision-making guidance is insufficient and knowledge of factors associated with DRPD is limited. We examined biopsychosocial factors associated with CIPN-related DR/PD in women undergoing taxane-based chemotherapy for early-stage breast cancer. Patients and methods: As part of a longitudinal study of CIPN measurement, women completed assessments before the first taxane infusion and at the final infusion or within the originally expected timeframe for the final infusion. Participants completed self-report measures of CIPN, pain, and physical and psychosocial wellbeing, and underwent physical testing of lower limb disability and Quantitative Sensory Testing for sensation and pain threshold to thermal, vibration, and touch stimuli in the feet and hands. Sociodemographic and clinical data were collected. Logistic regression was used to identify factors associated with neuropathy-related DRPD. Results: Among 121 participants, 66 (54.5%) received taxane-as-prescribed, 46 (38.0%) had neuropathy-related DRPD, and 9 (7.4%) had DR/PD for other reasons. Factors associated with neuropathy-related DR/PD were receipt of paclitaxel (Odds Ratio [OR]=75.05, 95% Confidence Interval [CI] 2.56-2197.96]), lower pre-treatment pain catastrophizing (OR=0.72, 95% CI: 0.54-0.95), and higher post-treatment neuropathic pain (OR=10.77, 95% CI: 1.99-58.15) and sensitivity to cold pain in the hand (OR=1.64, 95% CI: 1.05-2.56). Conclusion: CIPN-related DRPD is associated with paclitaxel treatment and post-treatment neuropathic pain and cold pain sensitivity in the hands. CIPN communication to healthcare providers may be influenced by pain catastrophizing, suggesting symptom appraisal may be an important factor in communication. Findings could contribute to clinical practice recommendations to facilitate treatment decision-making.

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Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors associated with chemotherapy-induced peripheral neuropathy-related reduced taxane dose or premature discontinuation in women with early-stage breast cancer

Gauthier

Robichaud

Bouffard

et al. 2021

Preprint

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“…The type of pain patients reported varied throughout the trial and has been published previously. 38 Generally neuropathic symptoms were more likely to be reported during chemotherapy and decreased over time. Physical therapy treatment for nerve disorders is well established for entrapment, neuropathic pain, nerve repair, and regeneration.…”

Section: Discussionmentioning

confidence: 98%

An Exploratory Randomized Trial of Physical Therapy for the Treatment of Chemotherapy-Induced Peripheral Neuropathy

Hammond

Pitz

Steinfeld

et al. 2020

Neurorehabil Neural Repair

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Background. Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of taxane treatment and cannot currently be prevented or adequately treated. Physical therapy is often used for neural rehabilitation following injury but has not been evaluated in this patient population. Methods. Single-blind, randomized controlled exploratory study compared standard care to a physical therapy home program (4 visits) throughout adjuvant taxane chemotherapy for stage I-III patients with breast cancer (n = 48). Patient questionnaires and quantitative sensory testing evaluated the treatment effect throughout chemotherapy to 6 months post treatment. Nonrandomized subgroup analysis observed effect of general exercise on sensory preservation comparing those reporting moderate exercise throughout chemotherapy to those that did not exercise regularly. Clinical Trial Registration. clinicaltrials.gov (NCT02239601). Results. The treatment group showed strong trends toward less pain (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.17-1.01; P = .053) and pain decreased over time (OR 0.85, 95% CI 0.76-0.94; P = .002). Pain pressure thresholds ( P = .034) and grip dynamometry ( P < .001) were improved in the treatment group. For the nonrandomized subgroup analysis, participants reporting general exercise had preservation of vibration (Left P = .001, Right P = .001) and normal heat pain thresholds (Left P = .021, Right P = .039) compared with more sedentary participants. Conclusion. Physical therapy home program may improve CIPN pain in the upper extremity for patients with breast cancer, and general exercise throughout chemotherapy treatment was observed to have correlated to preservation of sensory function. Further research is required to confirm the impact of a physical therapy home program on CIPN symptoms.

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“…Allodynia and hyperalgesia, such as cold hyperalgesia are clinical presentations of damage to small C fibers (Zhi et al, 2021). The study by Hammond et al however, was not able to confirm a loss of Aδ and C fibers (Hammond et al, 2019). TS measured in painful regions, contralaterally or between hands and feet, did not seem to be affected by CIPN(Martland et al, 2020).…”

Section: Altered Somatosensory Functioning In Breast Cancer Survivors...mentioning

confidence: 95%

Altered somatosensory functioning and mechanism‐based classification in breast cancer patients with persistent pain

Haenen

Dams

Groef

2022

The Anatomical Record

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Pain is one of the most frequent and persistent side effects of breast cancer treatment. Besides pain, breast cancer survivors (BCS) are prone to experience a myriad of other signs and symptoms related to altered somatosensory function, including for example, hypoesthesia, allodynia, and hyperalgesia, both at the local site of cancer and in remote body parts. Different breast cancer treatments can have a direct effect on somatosensory functioning, resulting in a wide range of these signs and symptoms. To our knowledge, currently no comprehensive overview exists on altered somatosensory functioning and resulting signs and symptoms in BCS with persistent pain. Investigating altered somatosensory functioning in this population could provide more insights in the underpinning pathophysiological mechanisms and consequently improve prevention and treatment in the future. Therefore, in this paper, first, normal somatosensory functioning is described. Second, quantitative sensory testing is presented as the recommend method to evaluate somatosensory functioning. Third, existing evidence on altered somatosensory functioning in BCS with persistent pain is summarized. Altered somatosensory functioning related to the most common cancer treatment modalities, including surgery and radiotherapy, hormone therapy, and chemotherapy are discussed. In addition, evidence on the presence of nociplastic pain as pain resulting from altered somatosensory functioning without evidence for nociception and/or neuropathy in BCS is summarized. At last, a discussion on this available evidence, limitations, and perspectives for clinical practice and for research are made.

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Quantitative sensory profiles of upper extremity chemotherapy induced peripheral neuropathy: Are there differences in sensory profiles for neuropathic versus nociceptive pain?

Abstract: Shay (2019) Quantitative sensory profiles of upper extremity chemotherapy induced peripheral neuropathy: Are there differences in sensory profiles for neuropathic versus nociceptive pain?,

Cited by 3 publications

References 48 publications

Factors associated with chemotherapy-induced peripheral neuropathy-related reduced taxane dose or premature discontinuation in women with early-stage breast cancer

Factors associated with chemotherapy-induced peripheral neuropathy-related reduced taxane dose or premature discontinuation in women with early-stage breast cancer

An Exploratory Randomized Trial of Physical Therapy for the Treatment of Chemotherapy-Induced Peripheral Neuropathy

Altered somatosensory functioning and mechanism‐based classification in breast cancer patients with persistent pain

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