Physician-assessed and patient-reported outcome measures in chemotherapy-induced sensory peripheral neurotoxicity: two sides of the same coin
Physician-assessed and patient-reported outcome measures in chemotherapy-induced sensory peripheral neurotoxicity: two sides of the same coin
复制标题
DOI：
10.1093/annonc/mdt409
复制
发表时间：
2014-01-01
影响因子：
50.5
通讯作者：
Cavaletti, G.
中科院分区：
文献类型：
--
作者：
Alberti, P.;Rossi, E.;Cavaletti, G.
背景资料：医疗保健提供者和患者之间对化疗诱导的周围神经毒性（CIPN）的不同感知和评估尚未得到充分解决，尽管这两种方法最终可能导致不一致，可能相互冲突的解释，特别是关于感觉障碍。采用美国国家癌症研究所通用毒性标准对281例稳定CIPN受试者进行了评价（NCI-CTC v.2.0）感觉量表、临床总神经病评分（TNSc（c））、改良的炎性神经病病因和治疗（INCAT）感觉总分（mISS）和欧洲癌症研究和治疗组织CIPN特定的自我报告问卷结果：患者的概率估计显示，EORTC QLQ-CIPN 20感觉评分总体上与NCI-CTC感觉评分高度相关。然而，TNSc的振动感知项目在EORTC QLQ-CIPN 20评分低于35时被评分为0的概率更高，在EORTC QLQ-CIPN 20评分介于35和50之间时被评分为2的概率更高，在EORTC QLQ-CIPN 20评分高于50时被评分为3级或4级的概率更高。线性模型显示，各mISS项目与EORTC QLQ-CIPN 20感觉评分之间存在显著的线性关系。结论：临床项目与患者感觉评分之间没有完美的相关性，大多数差异位于CIPN严重程度的中间水平。我们的数据表明，为了全面了解CIPN，包括对CIPN相关感觉障碍的严重程度和质量进行可靠评估，应始终结合临床和PRO措施。
Background: The different perception and assessment of chemotherapy-induced peripheral neurotoxicity (CIPN) between healthcare providers and patients has not yet been fully addressed, although these two approaches might eventually lead to inconsistent, possibly conflicting interpretation, especially regarding sensory impairment.Patients and methods: A cohort of 281 subjects with stable CIPN was evaluated with the National Cancer Institute-Common Toxicity Criteria (NCI-CTC v. 2.0) sensory scale, the clinical Total Neuropathy Score (TNSc (c)), the modified Inflammatory Neuropathy Cause and Treatment (INCAT) sensory sumscore (mISS) and the European Organization for Research and Treatment of Cancer CIPN specific self-report questionnaire (EORTC QOL-CIPN20).Results: Patients' probability estimates showed that the EORTC QLQ-CIPN20 sensory score was overall more highly related to the NCI-CTC sensory score. However, the vibration perception item of the TNSc had a higher probability to be scored 0 for EORTC QLQ-CIPN20 scores lower than 35, as vibration score 2 for EORTC QLQ-CIPN20 scores between 35 and 50 and as grade 3 or 4 for EORTC QLQ-CIPN20 scores higher than 50. The linear models showed a significant trend between each mISS item and increasing EORTC QLQ-CIPN20 sensory scores.Conclusion: None of the clinical items had a perfect relationship with patients' perception, and most of the discrepancies stood in the intermediate levels of CIPN severity. Our data indicate that to achieve a comprehensive knowledge of CIPN including a reliable assessment of both the severity and the quality of CIPN-related sensory impairment, clinical and PRO measures should be always combined.