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Comparison of two chemotherapy-induced peripheral neuropathy measurement approaches in children

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Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgements

The authors thank A. Logelin for her expertise in clinical trials documentation and Dr. K. Ness and P. Mitby for their helpful reviews of the manuscript. This study was supported by Award Number G11HD039786 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development.

Conflict of interest

The authors have no financial relationship with the funding agency and have no conflicts of interest to disclose. The authors have full control of all primary data and agree to allow the journal to review their data if requested.

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Authors and Affiliations

  1. Physical Therapy Program, St. Catherine University, 601 25th Ave S, Minneapolis, MN, USA

    L. S. Gilchrist

  2. Hematology and Oncology Program, Children’s Hospitals and Clinics of Minnesota, 2545 Chicago Ave S, Suite 412, Minneapolis, MN, 55404, USA

    L. S. Gilchrist & L. Tanner

  3. St. Croix Therapy, 742 Sterbenz Drive, Hudson, WI, 54016, USA

    L. Marais

  4. Developmental and Rehabilitation Services, Children’s Hospitals and Clinics of Minnesota, 2530 Chicago Ave S, Suite 267, Minneapolis, MN, 55404, USA

    L. Tanner

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  1. L. S. Gilchrist
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  2. L. Marais
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  3. L. Tanner
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Correspondence to L. S. Gilchrist.

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Gilchrist, L.S., Marais, L. & Tanner, L. Comparison of two chemotherapy-induced peripheral neuropathy measurement approaches in children. Support Care Cancer 22, 359–366 (2014). https://doi.org/10.1007/s00520-013-1981-6

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  • DOI: https://doi.org/10.1007/s00520-013-1981-6

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