Breast Medicine Service, Solid Tumor Division, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Epidemiology and Biostatistics, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Breast Cancer Res Treat. 2021 Apr;186(3):761-768. doi: 10.1007/s10549-020-06079-2. Epub 2021 Jan 28.
Chemotherapy-induced peripheral neuropathy (CIPN) is a common, debilitating side effect in cancer survivors. This study aimed to assess the characteristics of quantitative sensory testing (QST) and its correlation with patient-reported outcomes (PROs) in cancer patients with and without CIPN.
We conducted a cross-sectional analysis using baseline data from two clinical trials in solid tumor cancer survivors with no CIPN symptoms rated < 2 on a 0-10 Numerical Rating Scale (NRS) or moderate-to-severe CIPN rated ≥ 4 on the NRS. We collected PROs (NRS, Neuropathic Pain Scale, and Functional Assessment of Cancer Therapy-Gynecologic Oncology Group/Neurotoxicity subscale at baseline. QST [Tactile Threshold (TT), Vibration Threshold (VT), Thermal Threshold (THT)] measurements were used to assess sensory fiber function; they were compared between patients with and without CIPN using Wilcoxon rank-sum tests. We used Spearman correlation coefficients to estimate associations between PROs and QST in all patients.
Among 116 participants with CIPN (median NRS 5.00) and 10 participants without CIPN (median NRS 0.00), the median (interquartile range) TT was 3.84 (3.47, 4.12) and 3.53 (3.00, 3.84) in feet, respectively (p = 0.043). The median VT was 17.90 (9.42, 26.95) and 7.73 (5.94, 11.11) in feet, respectively (p = 0.001). Thermal cool threshold was 30.00 °C (28.90, 30.57) and 30.67 °C (30.57, 30.93), respectively (p = 0.007). Correlation coefficients between PROs and QST measures ranged between 0.02 and 0.50 in absolute magnitude.
Patients with moderate-to-severe CIPN had significantly impaired tactile, vibratory, and thermal thresholds compared to patients without CIPN. QST correlates with PROs, suggesting CIPN symptom severity may correspond to sensory fiber functionality. QST may be incorporated into future CIPN research.
化疗引起的周围神经病变(CIPN)是癌症幸存者中常见的、使人虚弱的副作用。本研究旨在评估癌症患者中有无 CIPN 时定量感觉测试(QST)的特征及其与患者报告的结局(PROs)的相关性。
我们对两项实体瘤癌症幸存者临床试验的基线数据进行了横断面分析,这些幸存者没有 CIPN 症状,数字评定量表(NRS)评分<2 或中重度 CIPN,NRS 评分≥4。我们收集了基线时的 PROs(NRS、神经性疼痛量表和癌症治疗功能评估-妇科肿瘤学组/神经毒性子量表)。使用 QST(触觉阈值(TT)、振动阈值(VT)、热阈值(THT))测量来评估感觉纤维功能;使用 Wilcoxon 秩和检验比较有和无 CIPN 的患者之间的差异。我们使用 Spearman 相关系数来估计所有患者中 PROs 和 QST 之间的相关性。
在 116 名有 CIPN(NRS 中位数 5.00)的参与者和 10 名无 CIPN(NRS 中位数 0.00)的参与者中,足部 TT 的中位数(四分位距)分别为 3.84(3.47,4.12)和 3.53(3.00,3.84)(p=0.043)。VT 的中位数分别为 17.90(9.42,26.95)和 7.73(5.94,11.11)(p=0.001)。足部的冷觉阈值分别为 30.00°C(28.90°C,30.57°C)和 30.67°C(30.57°C,30.93°C)(p=0.007)。PROs 和 QST 测量之间的相关系数绝对值在 0.02 到 0.50 之间。
与无 CIPN 的患者相比,中重度 CIPN 患者的触觉、振动和热阈值明显受损。QST 与 PROs 相关,表明 CIPN 症状的严重程度可能与感觉纤维功能相对应。QST 可能被纳入未来的 CIPN 研究中。