1592P - Chemotherapy induced peripheral neuropathy: the role of the modified total neuropathy score.

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Complications of Treatment
Presenter Sine Vasquez
Authors S. Vasquez1, M. Guidon2, E. McHugh2, O. Lennon2, O.S. Breathnach3
  • 1Physiotherapy, Beaumont Hospital Cancer Centre, 9 - Dublin/IE
  • 2Physiotherapy, Royal College of Surgeons in Ireland, Dublin - 2/IE
  • 3Medical Oncology, Beaumont Hospital Cancer Centre, 9 - Dublin/IE



Chemotherapy induced peripheral neuropathy (CIPN) is a common, potentially reversible side-effect of some chemotherapeutic agents. Common toxicity scales used in clinical practice are subjective, insensitive to change, and may underreport this phenomenon. The use of nerve conduction studies is invasive and impractical in routine practice. The modified total neuropathy score (mTNS) provides a comprehensive non-invasive measure of CIPN. CIPN is associated with decreased balance, function and quality of life (QoL). This association has to date been under-investigated.


All patients receiving neurotoxic chemotherapy regimes over a seven week period during July / August 2011 were identified using the hospital pharmacy database and once screened for inclusion/exclusion criteria, were invited to complete the mTNS, Berg Balance Scale (BBS), Timed Up and Go (TUG), and the FACT-G QoL questionnaire. mTNS scores were profiled and correlated with BBS, TUG and FACT-G using Spearmans correlation coefficient. All assessments were carried out under the supervision of a Senior Physiotherapist.


A total of 29 patients undergoing a variety of neurotoxic chemotherapy regimes (taxanes n = 9, vinca-alkaloids n = 3, platinums n = 13, combination platinum/taxane regimes n = 4) were assessed. The patients mTNS scores ranged between 1 and 12 (median score = 5), indicating that all patients had some signs of neuropathy on mTNS, and 93% (n = 27) had scores indicative of CIPN. No significant correlations were found between mTNS and BERG (r = -.289; p = 0.05), TUG (r = .136; p = 0.05), or FACT-G (r = 0.050; p = 0.05).


This study found a high prevalence of CIPN in patients treated with neurotoxic chemotherapy regimes as assessed by the mTNS. The mTNS provided a clinically applicable, sensitive screening tool for CIPN which could prove useful in clinical practice. mTNS did not correlate with BERG, TUG or FACT-G in this study, which may be due to relatively mild levels of CIPN and consequent subtle impairments which were not adequately captured by gross functional assessments.


All authors have declared no conflicts of interest.