Patients' and physicians' interpretation of chemotherapy-induced peripheral neurotoxicity

Guido Cavaletti*, David R. Cornblath, Ingemar S. J. Merkies, Tjeerd J. Postma, Emanela Rossi, Paola Alberti, Jordi Bruna, Andreas A. Argyriou, Chiara Briani, Roser Velasco, Haralabos P. Kalofonos, Dimitri Psimaras, Damien Ricard, Andrea Pace, Catharina G. Faber, Roy I. Lalisang, Dieta Brandsma, Susanne Koeppen, Simon Kerrigan, Angelo SchenoneWolfgang Grisold, Anna Mazzeo, Luca Padua, Susan G. Dorsey, Marta Penas-Prado, Maria G. Valsecchi, Barbara Frigeni, Francesca Lanzani, Laura Mattavelli, Maria Luisa Piatti, Davide Binda, Paolo Bidoli, Marina Cazzaniga, Diego Cortinovis, Edvina Galie, Marta Campagnolo, Andrea Salvalaggio, Marta Ruiz, Els K. Vanhoutte, W. Boogerd, J. Hense, Robin Grant, Dawn Storey, Lizia Reni, Chiara Demichelis, Annamaria Pessino, Giuseppe Granata, Massimo Leandri, I. Ghigliotti, Rosaria Plasmati, CI-PeriNomS Grp

*Corresponding author for this work

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Abstract

To test if and how chemotherapy-induced peripheral neurotoxicity (CIPN) is perceived differently by patients and physicians, making assessment and interpretation challenging. We performed a secondary analysis of the CI-PeriNomS study which included 281 patients with stable CIPN. We tested: (a) the association between patients' perception of activity limitation in performing eight common tasks and neurological impairment and (b) how the responses to questions related to these daily activities are interpreted by the treating oncologist. To achieve this, we compared patients' perception of their activity limitation with neurological assessment and the oncologists' blind interpretation. Distribution of the scores attributed by oncologists to each daily life maximum limitation ("impossible") generated three groups: Group 1 included limitations oncologists attributed mainly to motor impairment; Group 2 ones mainly attributed to sensory impairment and Group 3 ones with uncertain motor and sensory impairment. Only a subset of questions showed a significant trend between severity in subjective limitation, reported by patients, and neurological impairment. In Group 1, neurological examination confirmed motor impairment in only 51%-65% of patients; 76%-78% of them also had vibration perception impairment. In Group 2, sensory impairment ranged from 84% to 100%; some degree of motor impairment occurred in 43%-56% of them. In Group 3 strength reduction was observed in 49%-50% and sensory perception was altered in up to 82%. Interpretation provided by the panel of experienced oncologists was inconsistent with the neurological impairment. These observations highlight the need of a core set of outcome measures for future CIPN trials.

Original languageEnglish
Pages (from-to)111-119
Number of pages9
JournalJournal of the Peripheral Nervous System
Volume24
Issue number1
DOIs
Publication statusPublished - Mar 2019

Keywords

  • assessment
  • chemotherapy
  • neurotoxicity
  • patient reported outcome measures
  • side effects
  • OUTCOME MEASURES
  • NEUROPATHY CIPN
  • VALIDITY

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