Multi-center assessment of the Total Neuropathy Score for chemotherapy-induced peripheral neurotoxicity
Multi-center assessment of the Total Neuropathy Score for chemotherapy-induced peripheral neurotoxicity
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DOI：
10.1111/j.1085-9489.2006.00078.x
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发表时间：
2006-06-01
影响因子：
3.8
通讯作者：
Giussani, G
中科院分区：
文献类型：
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作者：
Cavaletti, G;Jann, S;Giussani, G
这项多中心研究的目的是用降低版本的总神经病变评分（TNS）来评估化疗引起的周围神经毒性（CIPN）的严重程度，并将结果与常用毒性量表进行比较。在11个不同的中心使用综合（临床+神经生理，TNSr）或临床（TNSc）检查以及国家癌症研究所-共同毒性标准（NCI-CTC） 2.0和东部合作肿瘤组（ECOG）评分对428名癌症患者进行了未选择的人群评估。TNSr与NCI-CTC 2.0和ECOG评分呈极显著相关；但考虑到评分范围的扩大，TNSr评价更为准确。此外，更简单、更快速的TNSc（仅基于临床神经学检查）可以准确地对CIPN进行评分，并与常见毒性评分相关联。当考虑感官项目时，相关性倾向于更紧密，但TNSr运动项目也与常见毒性量表的结果显着相关，而其他任何研究都没有专门研究TNSr运动项目。总之，本研究表明，TNSr是准确分级和报告CIPN的可靠工具，并与已知和广泛使用的常见毒性量表进行了正式比较，这是迄今为止唯一的支持。如果神经生理检查不可行，TNSc是一种有效的替代方法。与ECOG或NCI-CTC 2.0尺度相比，计算TNSr和TNSc所需的较长时间被更详细的CIPN特征知识所抵消。
The aim of this multi-center study was to assess with reduced versions of the Total Neuropathy Score (TNS), the severity of chemotherapy-induced peripheral neurotoxicity (CIPN), and to compare the results with those obtained with common toxicity scales. An unselected population of 428 cancer patients was evaluated at 11 different centers using a composite (clinical + neurophysiological, TNSr) or clinical (TNSc) examination and with the National Cancer Institute - Common Toxicity Criteria (NCI-CTC) 2.0 and Eastern Cooperative Oncology Group (ECOG) scores. A highly significant correlation was demonstrated between the TNSr and the NCI-CTC 2.0 and ECOG scores; but the TNSr evaluation was more accurate in view of the more extended score range. Also, the simpler and faster TNSc (based only on the clinical neurological examination) allowed to grade accurately CIPN and correlated with the common toxicity scores. The correlation tended to be closer when the sensory items were considered, but also the TNSr motor items, which were not specifically investigated in any other previous study, significantly correlated with the results of the common toxicity scales. In conclusion, this study suggests that the TNSr is a reliable tool for accurately grading and reporting CIPN, with the additional and so far unique support of a formal comparison with known and widely used common toxicity scales. The TNSc is a valid alternative if neurophysiological examination is not feasible. The longer time needed to calculate the TNSr and TNSc in comparison to the ECOG or the NCI-CTC 2.0 scales is offset by the more detailed knowledge of the CIPN characteristics.