Department of Medical Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
Support Care Cancer. 2019 Dec;27(12):4771-4777. doi: 10.1007/s00520-019-04781-6. Epub 2019 Apr 10.
Patient-reported outcomes (PRO) are becoming increasingly recognised as essential to comprehensively collect chemotherapy-induced peripheral neuropathy (CIPN) symptom information.
This study aimed to evaluate the utility and feasibility of CIPN PRO assessment tools in a real-world clinical setting through investigation of the correlation of PRO with NCI-CTCAE assessments particularly in relation to cumulative dose of chemotherapy. Patients receiving oxaliplatin or paclitaxel chemotherapy in Sydney, Australia, completed a questionnaire containing standardised CIPN PRO assessments (EORTC CIPN-20, PRO-CTCAE) via tablet device. PRO assessment scores were correlated with NCI-CTCAE grade determined by nursing assessment and analysed with respect to cumulative dose of chemotherapy.
There were 87 patients who completed a total of 145 questionnaires, 68 in patients receiving oxaliplatin and 77 in patients receiving paclitaxel. CIPN PRO scores were associated with NCI-CTCAE grade, for EORTC CIPN-20 (r = 0.19, p < 0.01) and PRO-CTCAE (r = 0.41, p < 0.01), although individual patient correlation was poor. PRO assessments, however, identified higher grade symptoms, in particular symptoms causing functional impairment, at lower doses of cumulative chemotherapy compared to NCI-CTCAE.
This study demonstrated that CIPN PRO may provide complementary information to nursing assessed NCI-CTCAE grade, particularly in earlier stages of chemotherapy and can be considered an important component in the comprehensive assessment of neuropathy.
患者报告的结局(PRO)越来越被认为是全面收集化疗引起的周围神经病变(CIPN)症状信息的必要手段。
本研究旨在通过调查 PRO 与 NCI-CTCAE 评估之间的相关性,特别是与化疗累积剂量的相关性,评估 CIPN PRO 评估工具在真实临床环境中的实用性和可行性。在澳大利亚悉尼接受奥沙利铂或紫杉醇化疗的患者通过平板电脑设备完成了一份包含标准化 CIPN PRO 评估(EORTC CIPN-20、PRO-CTCAE)的问卷。PRO 评估得分与由护理评估确定的 NCI-CTCAE 分级相关联,并根据化疗累积剂量进行分析。
共有 87 名患者完成了总共 145 份问卷,其中 68 名患者接受奥沙利铂治疗,77 名患者接受紫杉醇治疗。CIPN PRO 评分与 NCI-CTCAE 分级相关,EORTC CIPN-20(r=0.19,p<0.01)和 PRO-CTCAE(r=0.41,p<0.01),尽管个体患者相关性较差。然而,PRO 评估在与 NCI-CTCAE 相比,在较低的累积化疗剂量下,能够识别出更高等级的症状,特别是引起功能障碍的症状。
本研究表明,CIPN PRO 可能为护理评估的 NCI-CTCAE 分级提供补充信息,特别是在化疗早期阶段,可以被认为是神经病变综合评估的重要组成部分。