Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy
Abstract Background There are inconsistencies in the literature regarding the prevalence and assessment of chemotherapy-induced peripheral neuropathy (CIPN). This study explored CIPN natural history and its characteristics in patients receiving taxane- and platinum-based chemotherapy. Patients and m...
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| Format: | Article |
| Language: | English |
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BMC
2019-02-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-019-5302-4 |
| _version_ | 1828306870381576192 |
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| author | Alex Molassiotis Hui Lin Cheng Violeta Lopez Joseph S. K. Au Alexandre Chan Aishwarya Bandla K. T. Leung Y. C. Li K. H. Wong Lorna K. P. Suen Choi Wan Chan Janelle Yorke Carole Farrell Raghav Sundar |
| author_facet | Alex Molassiotis Hui Lin Cheng Violeta Lopez Joseph S. K. Au Alexandre Chan Aishwarya Bandla K. T. Leung Y. C. Li K. H. Wong Lorna K. P. Suen Choi Wan Chan Janelle Yorke Carole Farrell Raghav Sundar |
| author_sort | Alex Molassiotis |
| collection | DOAJ |
| description | Abstract Background There are inconsistencies in the literature regarding the prevalence and assessment of chemotherapy-induced peripheral neuropathy (CIPN). This study explored CIPN natural history and its characteristics in patients receiving taxane- and platinum-based chemotherapy. Patients and methods Multi-country multisite prospective longitudinal observational study. Patients were assessed before commencing and three weekly during chemotherapy for up to six cycles, and at 6,9, and 12 months using clinician-based scales (NCI-CTCAE; WHO-CIPN criterion), objective assessments (cotton wool test;10 g monofilament); patient-reported outcome measures (FACT/GOG-Ntx; EORTC-CIPN20), and Nerve Conduction Studies. Results In total, 343 patients were recruited in the cohort, providing 2399 observations. There was wide variation in CIPN prevalence rates using different assessments (14.2–53.4%). Prevalence of sensory neuropathy (and associated symptom profile) was also different in each type of chemotherapy, with paclitaxel (up to 63%) and oxaliplatin (up to 71.4%) showing the highest CIPN rates in most assessments and a more complex symptom profile. Peak prevalence was around the 6-month assessment (up to 71.4%). Motor neurotoxicity was common, particularly in the docetaxel subgroup (up to 22.1%; detected by NCI-CTCAE). There were relatively moderately-to-low correlations between scales (rs = 0.15,p < 0.05-rs = 0.48 p < 0.001), suggesting that they measure different neurotoxicity aspects from each other. Cumulative chemotherapy dose was not associated with onset and course of CIPN. Conclusion The historical variation reported in CIPN incidence and prevalence is possibly confounded by disagreement between assessment modalities. Clinical practice should consider assessment of motor neuropathy for neurotoxic chemotherapy. Current scales may not be all appropriate to measure CIPN in a valid way, and a combination of scales are needed. |
| first_indexed | 2024-04-13T14:48:50Z |
| format | Article |
| id | doaj.art-8eaff570c20a4c14abe9501252ee4216 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-13T14:48:50Z |
| publishDate | 2019-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-8eaff570c20a4c14abe9501252ee42162022-12-22T02:42:39ZengBMCBMC Cancer1471-24072019-02-0119111910.1186/s12885-019-5302-4Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapyAlex Molassiotis0Hui Lin Cheng1Violeta Lopez2Joseph S. K. Au3Alexandre Chan4Aishwarya Bandla5K. T. Leung6Y. C. Li7K. H. Wong8Lorna K. P. Suen9Choi Wan Chan10Janelle Yorke11Carole Farrell12Raghav Sundar13School of Nursing, The Hong Kong Polytechnic UniversitySchool of Nursing, The Hong Kong Polytechnic UniversityAlice Lee Centre for Nursing Studies, National University of SingaporeThe Hong Kong Adventist HospitalDepartment of Pharmacy, National University of SingaporeSingapore Institute for Neurotechnology (SINAPSE), National University of SingaporeDepartment of Clinical Oncology, Queen Elisabeth HospitalDepartment of Clinical Oncology, Queen Elisabeth HospitalDepartment of Clinical Oncology, Queen Elisabeth HospitalSchool of Nursing, The Hong Kong Polytechnic UniversitySchool of Nursing, The Hong Kong Polytechnic UniversityDivision of Nursing, Midwifery & Social Work, University of Manchester, UK and Christie NHS Foundation TrustDivision of Nursing, Midwifery & Social Work, University of Manchester, UK and Christie NHS Foundation TrustDepartment of Haematology-Oncology, National University Health SystemAbstract Background There are inconsistencies in the literature regarding the prevalence and assessment of chemotherapy-induced peripheral neuropathy (CIPN). This study explored CIPN natural history and its characteristics in patients receiving taxane- and platinum-based chemotherapy. Patients and methods Multi-country multisite prospective longitudinal observational study. Patients were assessed before commencing and three weekly during chemotherapy for up to six cycles, and at 6,9, and 12 months using clinician-based scales (NCI-CTCAE; WHO-CIPN criterion), objective assessments (cotton wool test;10 g monofilament); patient-reported outcome measures (FACT/GOG-Ntx; EORTC-CIPN20), and Nerve Conduction Studies. Results In total, 343 patients were recruited in the cohort, providing 2399 observations. There was wide variation in CIPN prevalence rates using different assessments (14.2–53.4%). Prevalence of sensory neuropathy (and associated symptom profile) was also different in each type of chemotherapy, with paclitaxel (up to 63%) and oxaliplatin (up to 71.4%) showing the highest CIPN rates in most assessments and a more complex symptom profile. Peak prevalence was around the 6-month assessment (up to 71.4%). Motor neurotoxicity was common, particularly in the docetaxel subgroup (up to 22.1%; detected by NCI-CTCAE). There were relatively moderately-to-low correlations between scales (rs = 0.15,p < 0.05-rs = 0.48 p < 0.001), suggesting that they measure different neurotoxicity aspects from each other. Cumulative chemotherapy dose was not associated with onset and course of CIPN. Conclusion The historical variation reported in CIPN incidence and prevalence is possibly confounded by disagreement between assessment modalities. Clinical practice should consider assessment of motor neuropathy for neurotoxic chemotherapy. Current scales may not be all appropriate to measure CIPN in a valid way, and a combination of scales are needed.http://link.springer.com/article/10.1186/s12885-019-5302-4Peripheral neuropathyNeurotoxicityChemotherapyCancerAssessmentTaxanes |
| spellingShingle | Alex Molassiotis Hui Lin Cheng Violeta Lopez Joseph S. K. Au Alexandre Chan Aishwarya Bandla K. T. Leung Y. C. Li K. H. Wong Lorna K. P. Suen Choi Wan Chan Janelle Yorke Carole Farrell Raghav Sundar Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy BMC Cancer Peripheral neuropathy Neurotoxicity Chemotherapy Cancer Assessment Taxanes |
| title | Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy |
| title_full | Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy |
| title_fullStr | Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy |
| title_full_unstemmed | Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy |
| title_short | Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy |
| title_sort | are we mis estimating chemotherapy induced peripheral neuropathy analysis of assessment methodologies from a prospective multinational longitudinal cohort study of patients receiving neurotoxic chemotherapy |
| topic | Peripheral neuropathy Neurotoxicity Chemotherapy Cancer Assessment Taxanes |
| url | http://link.springer.com/article/10.1186/s12885-019-5302-4 |
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