TY - JOUR
T1 - Patients' and physicians' interpretation of chemotherapy-induced peripheral neurotoxicity
AU - Cavaletti, Guido
AU - Cornblath, David R.
AU - Merkies, Ingemar S. J.
AU - Postma, Tjeerd J.
AU - Rossi, Emanela
AU - Alberti, Paola
AU - Bruna, Jordi
AU - Argyriou, Andreas A.
AU - Briani, Chiara
AU - Velasco, Roser
AU - Kalofonos, Haralabos P.
AU - Psimaras, Dimitri
AU - Ricard, Damien
AU - Pace, Andrea
AU - Faber, Catharina G.
AU - Lalisang, Roy I.
AU - Brandsma, Dieta
AU - Koeppen, Susanne
AU - Kerrigan, Simon
AU - Schenone, Angelo
AU - Grisold, Wolfgang
AU - Mazzeo, Anna
AU - Padua, Luca
AU - Dorsey, Susan G.
AU - Penas-Prado, Marta
AU - Valsecchi, Maria G.
AU - the CI-PeriNomS Group
AU - Faber, C. G.
AU - Frigeni, B.
AU - Lanzani, F.
AU - Mattavelli, L.
AU - Piatti, M. L.
AU - Binda, D.
AU - Bidoli, P.
AU - Cazzaniga, M.
AU - Cortinovis, D.
AU - Galiè, E.
AU - Campagnolo, M.
AU - Salvalaggio, A.
AU - Ruiz, M.
AU - Vanhoutte, E. K.
AU - Boogerd, W.
AU - Hense, J.
AU - Grant, R.
AU - Storey, D.
AU - Reni, L.
AU - Demichelis, C.
AU - Pessino, A.
AU - Granata, G.
AU - Heimans, J. J.
AU - Meijer, R. J.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - 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.
AB - 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.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85061269274&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30672664
U2 - https://doi.org/10.1111/jns.12306
DO - https://doi.org/10.1111/jns.12306
M3 - Article
C2 - 30672664
SN - 1085-9489
VL - 24
SP - 111
EP - 119
JO - Journal of the peripheral nervous system
JF - Journal of the peripheral nervous system
IS - 1
ER -