Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/80661
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, HL 
Lopez, V
Au, JSK
Chan, A
Bandla, A
Leung, KT
Li, YC
Wong, KH
Suen, LKP 
Chan, CW 
Yorke, J
Farrell, C
Sundar, R
Keywords: Assessment
Cancer
Chemotherapy
Neurotoxicity
Peripheral neuropathy
Platins
Taxanes
Issue Date: 2019
Publisher: BioMed Central
Source: BMC cancer, 2019, v. 19, 132, p. 1-19 How to cite?
Journal: BMC cancer 
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.
URI: http://hdl.handle.net/10397/80661
ISSN: 1471-2407
DOI: 10.1186/s12885-019-5302-4
Rights: © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The following publication Molassiotis, A., Cheng, H. L., Lopez, V., Au, J. S. K., Chan, A., Bandla, A., ... & 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, 132, 1-19 is available at https://doi.org/10.1186/s12885-019-5302-4
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