Wang Mian, Bandla Aishwarya, Sundar Raghav, Molassiotis Alex
School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
The N.1 Institute for Health, National University of Singapore, Singapore.
Eur J Oncol Nurs. 2022 Oct;60:102196. doi: 10.1016/j.ejon.2022.102196. Epub 2022 Aug 29.
Nerve conduction studies (NCS) have been suggested as gold standard for diagnosing and monitoring peripheral neuropathies. However, its value in measuring chemotherapy-induced peripheral neuropathy (CIPN) is not clearly understood. Our study aimed to examine the role and performance of NCS in CIPN assessment through a secondary analysis.
Pooled data pertaining to NCS, clinical examination, symptoms, and quality of life from patients with cancer enrolled in five studies were used. These patients had received taxane- or oxaliplatin-based chemotherapy. The data were grouped in cohorts of before initiation of chemotherapy, during chemotherapy, at the end of chemotherapy, and at recovery stage according to the time points of assessment in the original studies.
Data was available from a total of 84 patients (74 females and 10 males) and a total of 160 NCS assessments. NCS results confirmed that damage of sensory nerves is more profound than motor nerves in patients at different stages of neurotoxic chemotherapy. No strong correlation was identified between NCS parameters and clinical examination outcomes as well as patient-reported symptoms and quality of life. NCS did not perform well in discriminating clinically relevant CIPN (area under the curve [AUC] = 0.51-0.77).
Our findings suggest that NCS may have limited value in diagnosing CIPN. Future prospective studies with baseline values are needed to clarify our tentative conclusions.
神经传导研究（NCS）已被视为诊断和监测周围神经病变的金标准。然而，其在测量化疗引起的周围神经病变（CIPN）方面的价值尚不清楚。我们的研究旨在通过二次分析来检验NCS在CIPN评估中的作用和表现。
使用了五项研究中纳入的癌症患者的NCS、临床检查、症状和生活质量的汇总数据。这些患者接受了基于紫杉烷或奥沙利铂的化疗。根据原始研究中的评估时间点，将数据分为化疗开始前、化疗期间、化疗结束时和恢复阶段的队列。
共有84例患者（74例女性和10例男性）的数据可用，共进行了160次NCS评估。NCS结果证实，在神经毒性化疗不同阶段的患者中，感觉神经损伤比运动神经更严重。未发现NCS参数与临床检查结果以及患者报告的症状和生活质量之间存在强相关性。NCS在区分临床相关的CIPN方面表现不佳（曲线下面积[AUC]=0.51-0.77）。
我们的研究结果表明，NCS在诊断CIPN方面可能价值有限。需要未来进行有基线值的前瞻性研究来阐明我们的初步结论。
