Comparison of two chemotherapy-induced peripheral neuropathy measurement approaches in children

• Published in: Supportive care in cancer Vol. 22; no. 2; pp. 359 - 366
• Main Authors: Gilchrist, L. S., Marais, L., Tanner, L.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2014; Springer; Springer Nature B.V
• Subjects: Adolescent; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer; Chemotherapy; Child; Child, Preschool; Childrens health; Cisplatin - administration & dosage; Cisplatin - adverse effects; Cisplatin - therapeutic use; Comparative analysis; Complications and side effects; Female; Humans; Induction Chemotherapy; Lymphoma - drug therapy; Male; Medicine; Medicine & Public Health; Neoplasms - drug therapy; Neurotoxicity; Neurotoxicity Syndromes - diagnosis; Neurotoxicity Syndromes - drug therapy; Neurotoxicity Syndromes - etiology; Non-Hodgkin's lymphomas; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Pediatrics; Peripheral Nervous System Diseases - chemically induced; Peripheral Nervous System Diseases - diagnosis; Peripheral Nervous System Diseases - drug therapy; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Prospective Studies; Rehabilitation Medicine; Vincristine - administration & dosage; Vincristine - adverse effects; Pediatrics; Neurotoxicity; Cancer
• ISSN: 0941-4355; 1433-7339; 1433-7339
• DOI: 10.1007/s00520-013-1981-6

Purpose Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer treatment in children; however, measurement of CIPN has been hampered by limitations in available tools, which may impact prevalence estimates. The purpose of this study was to assess the relative ability of the Common Terminology Criteria (CTCAE) rating process to detect sensory and motor neuropathy as compared to administration of the pediatric modified Total Neuropathy Score (peds-mTNS). Methods The ped-mTNS was administered to 60 children/adolescents ages 5–18 undergoing treatment for acute lymphocytic leukemia, lymphoma, or non-CNS solid tumors. CTCAE v3.0 scores for the same time point were abstracted from the medical record by a separate trained rater. Comparisons were made between scores using descriptive statistics, correlations, and specificity and sensitivity calculations. Results The median ped-mTNS score was 9 (32 possible), while the median sensory and motor CTCAE ratings were 0 and 2, respectively (4 and 5 possible, respectively). There was no correlation between ped-mTNS and combined sensory and motor CTCAE scores. The only ped-mTNS item with significant correlation to CTCAE scoring was strength testing. Medical record abstraction of CTCAE scores failed to identify sensory neuropathy in 40 % and significant motor neuropathy (manual muscle test grade 3 or worse) in 15 % of subjects. Conclusions Prospective measures of CIPN using the ped-mTNS identified a far greater proportion of subjects with peripheral neurotoxicity as compared to CTCAE v3.0 sensory and motor neuropathy ratings, and thus we recommend the use of a specific measure of CIPN such as the ped-mTNS.