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Chemotherapy induced peripheral neuropathy: the modified total neuropathy score in clinical practice

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Abstract

Background

Chemotherapy-induced peripheral neuropathy (CIPN) is a common, potentially reversible side effect of some chemotherapeutic agents. CIPN is associated with decreased balance, function and quality of life (QoL). This association has to date been under-investigated.

Aims

To profile patients presenting with CIPN using the modified Total Neuropathy Score (mTNS) in this cross-sectional study and to examine the relationship between CIPN (measured by mTNS) and indices of balance, quality of life (QoL) and function.

Methods

Patients receiving neurotoxic chemotherapy regimens were identified using hospital databases. Those who did not have a pre-existing neuropathy were invited to complete mTNS, Berg Balance Scale (BBS), timed up and go (TUG), and FACT-G QoL questionnaire. mTNS scores were profiled and also correlated with BBS, TUG and FACT-G using Spearmans correlation coefficient.

Results

A total of 29 patients undergoing neurotoxic chemotherapy regimens were tested. The patients mTNS scores ranged between 1 and 12 (median = 5), indicating that all patients had clinical evidence of neuropathy on mTNS. No significant correlations were found between mTNS and BERG (r = −0.29), TUG (r = 0.14), or FACT-G (r = 0.05).

Conclusions

This study found a high prevalence of CIPN in patients treated with neurotoxic chemotherapy regimens. The mTNS provided a clinically applicable, sensitive screening tool for CIPN which could prove useful in clinical practice. mTNS did not correlate with BBS, TUG or FACT-G in this sample, possibly due to relatively mild levels of CIPN and consequent subtle impairments which were not adequately captured by gross functional assessments.

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References

  1. Postma TJ, Heimans JJ, Muller MJ et al (1998) Pitfalls in grading severity of chemotherapy-induced peripheral neuropathy. Ann Oncol 9:739–744

    Article  CAS  PubMed  Google Scholar 

  2. Visovsky C (2003) Chemotherapy-induced peripheral neuropathy. Cancer Invest 21(3):439–445

    Article  PubMed  Google Scholar 

  3. Dunlap B, Paice JA (2006) Chemotherapy-induced peripheral neuropathy: a need for standardization in measurement. J Support Oncol 4(8):398–399

    PubMed  Google Scholar 

  4. Visovsky C, Daly B (2004) Clinical evaluation and patterns of chemotherapy-induced peripheral neuropathy. J Am Acad Nurse Pract 16(8):353–359 (PMID: 15455708)

    Article  PubMed  Google Scholar 

  5. Wampler MA, Miaskowski C, Hamel K et al (2006) The modified total neuropathy score: a clinically feasible and valid measure of taxane-induced peripheral neuropathy in women with breast cancer. J Support Oncol 4(8):W9–W16

    Google Scholar 

  6. Lavoie Smith E, Beck S, Cohen J (2010) The reliability and validity of a modified total neuropathy score-reduced and neuropathic pain severity items when used to measure chemotherapy-induced peripheral neuropathy in patients receiving taxanes and platinums. Cancer Nurs 33(3):173–183

    Article  Google Scholar 

  7. Visovsky C, Collins M, Abbott L, Aschenbrenner J, Hart C (2007) Putting evidence into practise: evidence-based interventions for chemotherapy-induced peripheral neuropathy. CJON 11(6):901–913

    Article  Google Scholar 

  8. Chaudhry V, Rowinsky E, Sartorius S et al (1994) Peripheral neuropathy from taxol and cisplatin combination chemotherapy: clinical and electrophysiological studies. Ann Neurol 35(3):304–311

    Article  CAS  PubMed  Google Scholar 

  9. Fuller G (2004) Neurological examination made easy, 3rd edn. Churchill Livingstone, England

    Google Scholar 

  10. Shumway-Cook A, Braver S, Woollacott M (2000) Predicting the probability for falls in community-dwelling older adults using the timed up and go test. Phys Ther 80(9):896–903

    CAS  PubMed  Google Scholar 

  11. Ng S, Hui-Chan CW (2005) The timed up and go test: its reliability and association with lower limb impairments and locomotor capacities in people with chronic stroke. Arch Phys Med Rehabil 86(6):1641–1647

    Article  PubMed  Google Scholar 

  12. La Porto F, Caselli S, Susassi S et al (2012) Is the Berg Balance Scale an internally valid and reliable measure of balance across different aetiologies in neurorehabilitation? A revisited Rasch analysis study. Arch Phys Med Rehabil 93(7):1209–1216

    Article  Google Scholar 

  13. King M, Stockler M, Cella D et al (2010) Meta-analysis provides evidence-based effect sizes for a cancer-specific quality-of-life questionnaire, the FACT-G. J Clin Epidemiol 63:270–281

    Article  PubMed  Google Scholar 

  14. Webster K, Cella D, Yost K (2003) The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System: properties, applications and interpretation. Health Qual Life Outcomes 1:79

    Article  PubMed Central  PubMed  Google Scholar 

  15. Shumway-Cook A, Baldwin M, Nayak L et al (1997) Predicting the probability for falls in community-dwelling older adults. Phys Ther 77:812–819

    CAS  PubMed  Google Scholar 

  16. Carr JH, Shepherd RB (1998) Neurological rehabilitation: optimising motor performance. Butterworth-Heinemann, Oxford, UK

    Google Scholar 

  17. Argyriou AA, Polychronopoulos P, Koutras A et al (2006) Is advanced age associated with increased incidence and severity of chemotherapy-induced peripheral neuropathy? Support Care Cancer 14(3):223–229

    Article  PubMed  Google Scholar 

  18. Bakitas M (2007) Background noise—the experience of chemotherapy-induced peripheral neuropathy. Nurs Res 56(5):323–331

    Article  PubMed  Google Scholar 

  19. Lavoie Smith E, Cohen J, Pett M et al (2008) The total neuropathy score: a tool for measuring chemotherapy-induced peripheral neuropathy. Oncol Nurs Forum 35(1):96–102

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Physiotherapy, Beaumont Hospital Cancer Centre, Dublin, Ireland

    S. Vasquez

  2. Royal College of Surgeons in Ireland, Dublin, Ireland

    M. Guidon, E. McHugh & O. Lennon

  3. Department of Medical Oncology, Beaumont Hospital Cancer Centre, Dublin, Ireland

    L. Grogan & O. S. Breathnach

Authors
  1. S. Vasquez
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  2. M. Guidon
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  3. E. McHugh
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  4. O. Lennon
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  5. L. Grogan
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  6. O. S. Breathnach
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Correspondence to S. Vasquez.

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Vasquez, S., Guidon, M., McHugh, E. et al. Chemotherapy induced peripheral neuropathy: the modified total neuropathy score in clinical practice. Ir J Med Sci 183, 53–58 (2014). https://doi.org/10.1007/s11845-013-0971-5

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  • DOI: https://doi.org/10.1007/s11845-013-0971-5

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