Chemotherapy-induced peripheral neurotoxicity (CIPN) seriously deteriorates patient's QOL. CIPN worsens in a cumulative dose-dependent manner and is often the major dose-limiting toxicity for many anticancer agents. Assessment of CIPN usually depends on subjective evaluation using a semi-quantitative scale, NCI-CTCAE. We prospectively assessed CIPN using a newly-developed point-of-care nerve conduction device (POCD).
Patients who were undergoing chemotherapy and clinically diagnosed CIPN of grade (G) 1 or worse according to NCI-CTCAE were evaluated for sural nerve amplitude potentials (SNAP, &mgr;V), a quantitative measure of the axonal degeneration, and sural nerve conduction velocity (SNCV, m/s), that of the degree of demyelination, using a portable and automated POCD (DPN-Check®, Neurometrix Inc.) that has been validated for the assessment of diabetic peripheral neuropathy. The SNAP/SNCV were compared with the reference from normal population, as well as the toxicity grade.
A total of 50 patients (G1/G2/G3: 21/18/11) were enrolled. Patients were; male/female: 22/28; median age 64 (34-85); cancer origin: colon in 13 pts, breast 8, gastric 5, pancreas 5, gynecology 5, hematology 7 and others 7; responsible drugs (median cumulative dose): paclitaxel in 16 pts (3,315 mg), docetaxel 14 (517.5 mg), oxaliplatin 15 (1,020 mg), bortezomib 3 (171 mg), vincristine 6 (8 mg), nab-paclitaxel 7 (1,400 mg), and cisplatin 5 (300 mg). Mean SNAP were 8.45 Â± 3.67 in those with G1 CIPN, 5.41 Â± 2.68 G2, and 2.45 Â± 1.52 G3. Mean SNCV were 49.71 Â± 4.77 G1, 48.74 Â± 6.33 G2, and 44.14 Â± 7.31 G3. The SNAP of the patients with G2 or worse were significantly lower than the reference (p = 0.010), whereas the SNCV from those studied were similar to the reference. The SNAP had negatively correlated with the CTCAE grade (r= -0.685, p< 0.0001).
The POCD was validated to be effective for quantitative assessment of CIPN.
Clinical trial identification
All authors have declared no conflicts of interest.