Comparison of two chemotherapy-induced peripheral neuropathy measurement approaches in children
Comparison of two chemotherapy-induced peripheral neuropathy measurement approaches in children
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DOI：
10.1007/s00520-013-1981-6
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发表时间：
2014-02-01
影响因子：
3.1
通讯作者：
Tanner, L.
中科院分区：
文献类型：
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作者：
Gilchrist, L. S.;Marais, L.;Tanner, L.
化疗引起的周围神经病变（CIPN）是儿童癌症治疗的常见副作用;然而，CIPN的测量受到现有工具的限制，这可能会影响患病率估计。本研究的目的是评估通用术语标准（CTCAE）评级过程与儿科改良总神经病评分（peds-mTNS）的施用相比检测感觉和运动神经病的相对能力。将ped-mTNS施用给60名5-18岁的儿童/青少年，其正在接受急性淋巴细胞白血病、淋巴瘤或非CNS实体瘤的治疗。同一时间点的CTCAE v3.0评分由单独的经过培训的评估者从病历中提取。使用描述性统计、相关性、特异性和敏感性计算对评分进行比较，ped-mTNS评分中位数为9分（32分可能），而感觉和运动CTCAE评分中位数分别为0分和2分（4分可能）。ped-mTNS与感觉和运动CTCAE评分无相关性。唯一与CTCAE评分显著相关的ped-mTNS项目是力量测试。CTCAE评分的病历摘要未能识别40%的感觉神经病变和显著的运动神经病变使用ped-mTNS的CIPN的前瞻性测量确定了与CTCAE v3.0感觉和运动神经病变评级相比，具有周围神经毒性的受试者的比例大得多，因此我们推荐使用特定的CIPN测量，例如ped-mTNS。
Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer treatment in children; however, measurement of CIPN has been hampered by limitations in available tools, which may impact prevalence estimates. The purpose of this study was to assess the relative ability of the Common Terminology Criteria (CTCAE) rating process to detect sensory and motor neuropathy as compared to administration of the pediatric modified Total Neuropathy Score (peds-mTNS).The ped-mTNS was administered to 60 children/adolescents ages 5-18 undergoing treatment for acute lymphocytic leukemia, lymphoma, or non-CNS solid tumors. CTCAE v3.0 scores for the same time point were abstracted from the medical record by a separate trained rater. Comparisons were made between scores using descriptive statistics, correlations, and specificity and sensitivity calculations.The median ped-mTNS score was 9 (32 possible), while the median sensory and motor CTCAE ratings were 0 and 2, respectively (4 and 5 possible, respectively). There was no correlation between ped-mTNS and combined sensory and motor CTCAE scores. The only ped-mTNS item with significant correlation to CTCAE scoring was strength testing. Medical record abstraction of CTCAE scores failed to identify sensory neuropathy in 40 % and significant motor neuropathy (manual muscle test grade 3 or worse) in 15 % of subjects.Prospective measures of CIPN using the ped-mTNS identified a far greater proportion of subjects with peripheral neurotoxicity as compared to CTCAE v3.0 sensory and motor neuropathy ratings, and thus we recommend the use of a specific measure of CIPN such as the ped-mTNS.