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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 | Authors: | Molassiotis, A Cheng, H.L Lopez, V Au, J.S.K Chan, A Bandla, A Leung, K.T Li, Y.C Wong, K.H Suen, L.K.P Chan, C.W Yorke, J Farrell, C Sundar, R |
Keywords: | carboplatin cisplatin docetaxel oxaliplatin paclitaxel platinum derivative taxane derivative antineoplastic agent adult aged Article clinical assessment clinical feature clinical practice cohort analysis controlled study correlation analysis disease course disease severity female human incidence longitudinal study major clinical study male middle aged motor neuropathy multiple cycle treatment nerve conduction observational study patient-reported outcome peripheral neuropathy prevalence prospective study rating scale sensory neuropathy cancer staging clinical trial complication dose response multicenter study neoplasm peripheral neuropathy quality of life severity of illness index very elderly Adult Aged Aged, 80 and over Antineoplastic Agents Antineoplastic Combined Chemotherapy Protocols Cohort Studies Dose-Response Relationship, Drug Female Humans Longitudinal Studies Male Middle Aged Neoplasm Staging Neoplasms Patient Reported Outcome Measures Peripheral Nervous System Diseases Prevalence Prospective Studies Quality of Life Severity of Illness Index |
Issue Date: | 2019 | Citation: | Molassiotis, A, Cheng, H.L, Lopez, V, Au, J.S.K, Chan, A, Bandla, A, Leung, K.T, Li, Y.C, Wong, K.H, Suen, L.K.P, Chan, C.W, Yorke, J, Farrell, C, Sundar, R (2019). 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 19 (1) : 132. ScholarBank@NUS Repository. https://doi.org/10.1186/s12885-019-5302-4 | Rights: | Attribution 4.0 International | 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 (r s = 0.15,p < 0.05-r s = 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. © 2019 The Author(s). | Source Title: | BMC Cancer | URI: | https://scholarbank.nus.edu.sg/handle/10635/181161 | ISSN: | 14712407 | DOI: | 10.1186/s12885-019-5302-4 | Rights: | Attribution 4.0 International |
Appears in Collections: | Elements Staff Publications |
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