Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy
Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy
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DOI：
10.1186/s12885-019-5302-4
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发表时间：
2019-02-08
期刊：
影响因子：
3.8
通讯作者：
Sundar, Raghav
中科院分区：
文献类型：
--
作者：
Molassiotis, Alex;Cheng, Hui Lin;Sundar, Raghav
背景关于化疗引起的周围神经病变（CIPN）的患病率和评估，文献中存在不一致。本研究探讨了CIPN的自然历史和它的特点，在接受紫杉烷和铂为基础的chemotherapy.Patients和methodsMulti-country multisite前瞻性纵向观察研究。患者在化疗开始前和化疗期间每3周进行一次评估，最多持续6个周期，并在6、9和12个月时使用基于临床医师的量表进行评估（NCI-CTCAE; WHO-CIPN标准），客观评估（棉絮试验; 10 g单丝）;患者报告的结局指标（FACT/GOG-Ntx; EORTC-CIPN 20）和神经传导研究.ResultsIn总数，343例患者被招募在队列中，提供2399观察。使用不同的评估方法，CIPN患病率差异很大（14.2-53.4%）。感觉神经病变（和相关症状特征）的患病率在每种类型的化疗中也不同，紫杉醇（高达63%）和奥沙利铂（高达71.4%）在大多数评估中显示出最高的CIPN发生率和更复杂的症状特征。患病率高峰出现在6个月评估前后（高达71.4%）。运动神经毒性常见，尤其是在多西他赛亚组中（高达22.1%;通过NCI-CTCAE检测）。各量表之间的相关性为中-低相关（r（s）= 0.15，p
BackgroundThere 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 methodsMulti-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 12months using clinician-based scales (NCI-CTCAE; WHO-CIPN criterion), objective assessments (cotton wool test;10g monofilament); patient-reported outcome measures (FACT/GOG-Ntx; EORTC-CIPN20), and Nerve Conduction Studies.ResultsIn 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