The validity of neuropathy and neuropathic pain measures in patients with cancer receiving taxanes and platinums.

PURPOSE/OBJECTIVES: To assess the validity of neuropathy and neuropathic pain-measurement approaches.

DESIGN

Cross-sectional measurement study.

SETTING

Two comprehensive cancer centers in the northeastern United States.

SAMPLE

117 patients with cancer in an outpatient setting.

METHODS

Participants were assessed using the five-component Total Neuropathy Score-reduced (TNSr), the TNSr short form (TNSr-SF), individual TNSr items, the Neuropathic Pain Scale for chemotherapy-induced neuropathy (NPS-CIN), and the National Cancer Institute's Common Toxicity Criteria™, version 3.0 (NCI-CTC).

MAIN RESEARCH VARIABLES

Neuropathy and pain measure scores, cumulative and per M2 chemotherapy dosage, comorbid risk factors, drug class, and the number of neurotoxic drugs received.

FINDINGS

TNSr, TNSr-SF, and tendon reflex scores were greater in patients receiving higher cumulative (z range = -2.2 to -3.6; p range = 0.01 to < 0.001) and per M2 (z range = -1.8 to -2.4; p range = 0.04 to < 0.001) chemotherapy doses. Scores from most neuropathy and pain measures were higher in patients with comorbid illnesses (z range = -1.79 to -3.51; p range = 0.03 to < 0.001). Sensory NCI-CTC scores were higher in patients receiving higher cumulative chemotherapy dosage (z = -2.1; p = 0.02). Only the sensory NCI-CTC correlated with other measures (r range = 0.22-0.63; p range = 0.05 to < 0.001).

CONCLUSIONS

Findings support the validity of the TNSr, TNSr-SF, tendon reflex item, NPS-CIN, and NCI-CTC sensory grading scale when measuring taxane and platinum-induced neuropathy. However, additional validity testing is warranted.

IMPLICATIONS FOR NURSING

Comprehensive neuropathy and pain measures mainly used by researchers and neurologists were simplified to more clinically useful tools for use by nurses when monitoring chemotherapy-induced peripheral neuropathy.