The pediatric-modified total neuropathy score: a reliable and valid measure of chemotherapy-induced peripheral neuropathy in children with non-CNS cancers

• Published in: Supportive care in cancer Vol. 21; no. 3; pp. 847 - 856
• Main Authors: Gilchrist, Laura S., Tanner, Lynn
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.03.2013; Springer; Springer Nature B.V
• Subjects: Adolescent; Age Factors; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Cancer; Case-Control Studies; Chemotherapy; Child; Child, Preschool; Female; Humans; Leukemia; Lymphomas; Male; Measurement; Medicine; Medicine & Public Health; Neoplasms - drug therapy; Neurotoxicity; Neurotoxicity Syndromes - diagnosis; Neurotoxicity Syndromes - etiology; Nursing; Nursing Research; Observer Variation; Oncology; Original Article; Pain Medicine; Pediatrics; Peripheral Nervous System Diseases - chemically induced; Peripheral Nervous System Diseases - diagnosis; Rehabilitation Medicine; Reproducibility of Results; Side effects; Pediatrics; Chemotherapy; Neuropathy; Cancer
• ISSN: 0941-4355; 1433-7339; 1433-7339
• DOI: 10.1007/s00520-012-1591-8

Background Neurotoxicity is a common side-effect of cancer treatment, but no scales have been validated for the pediatric population. The objective of this study was to test the reliability and validity of the pediatric modified-Total Neuropathy Scale (ped-mTNS) to measure chemotherapy-induced peripheral neuropathy in school-aged children. Methods Forty-one subjects aged 5–18 years undergoing chemotherapy with vincristine or cisplatin and 41 age- and gender-matched controls completed study measures. Subjects were tested with the ped-mTNS at a specified time during treatment. Standardized measures of balance and hand function were completed concurrently. Internal consistency of the ped-mTNS was evaluated using Chronbach’s alpha. Validity was tested by comparing case and control ped-mTNS scores as well as testing the hypothesis that ped-mTNS scores would be associated with scores on tests of balance and manual dexterity. Inter-rater and test–retest reliability were each assessed in a subset of 10 subjects. Results Twenty-three subjects with acute lymphoblastic leukemia, six with lymphoma, and 12 with solid tumors completed measures along with 41 age- and gender-matched controls. Internal consistency was acceptable with a Chronbach’s alpha of 0.76. Children undergoing treatment for cancer had significantly worse scores on the ped-mTNS compared to controls (subjects, 8.7 ± 4.2; controls, 1.4 ± 0.9; p  < 0.001). As hypothesized, scores on the ped-mTNS were associated with measures of balance and manual dexterity. Inter-rater and test–retest reliability was acceptable (intraclass correlation coefficients >0.9 each). Conclusions The ped-mTNS is a reliable and valid measure of chemotherapy-induced peripheral neuropathy in school-aged children that is associated with relevant functional limitations.