Faculty of Medicine and Health, School of Medical Sciences, Brain and Mind Centre, the University of Sydney, Sydney, Australia.
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Expert Rev Neurother. 2022 Jan;22(1):65-76. doi: 10.1080/14737175.2022.2018300. Epub 2022 Jan 11.
Chemotherapy-induced peripheral neurotoxicity (CIPN) remains a significant toxicity in cancer survivors without preventative strategies or rehabilitation. Exercise and physical activity-based interventions have demonstrated promise in reducing existing CIPN symptoms and potentially preventing toxicity, however there is a significant gap in evidence due to the lack of quality clinical trials and appropriate outcome measures.
We systematically reviewed outcome measures in CIPN exercise and physical rehabilitation studies with expert panel consensus via the Peripheral Nerve Society Toxic Neuropathy Consortium to provide recommendations for future trials. Across 26 studies, 75 outcome measures were identified and grouped into 16 domains within three core areas - measures of manifestations of CIPN (e.g. symptoms/signs), measures of the impact of CIPN and other outcome measures.
This article provides a conceptual framework for CIPN outcome measures and highlights the need for definition of a core outcome measures set. The authors provide recommendations for CIPN exercise and physical rehabilitation trial design and outcome measure selection. The development of a core outcome measure set will be critical in the search for neuroprotective and treatment approaches to support cancer survivors and to address the gap in the identification of effective rehabilitation and treatment options for CIPN.
化疗引起的周围神经毒性(CIPN)仍然是癌症幸存者的一个重大毒性问题,目前尚无预防策略或康复措施。运动和基于身体活动的干预措施已被证明可以减轻现有的 CIPN 症状,并有可能预防毒性,但由于缺乏高质量的临床试验和适当的结局指标,证据仍存在很大差距。
我们通过周围神经学会毒性神经病变联盟的专家小组共识,对 CIPN 运动和身体康复研究中的结局指标进行了系统回顾,为未来的试验提供了建议。在 26 项研究中,共确定了 75 个结局指标,并分为三个核心领域的 16 个领域,这些领域包括:CIPN 表现的测量指标(例如症状/体征)、CIPN 影响的测量指标和其他结局指标。
本文为 CIPN 结局指标提供了一个概念框架,并强调了定义核心结局指标集的必要性。作者为 CIPN 运动和身体康复试验设计和结局指标选择提供了建议。核心结局指标集的开发对于寻找神经保护和治疗方法以支持癌症幸存者以及解决 CIPN 有效康复和治疗选择的识别差距至关重要。