Quantitative Sensory Testing at Baseline and during Cycle 1 Oxaliplatin Infusion Detects Subclinical Peripheral Neuropathy and Predicts Clinically Overt Chronic Neuropathy in Gastrointestinal Malignancies

Sangeetha M. Reddy, Maxwell T. Vergo, Judith Paice, Nancy Kwon, Irene B. Helenowski, Al B Benson III, Mary Frances Mulcahy, Halla S Nimeiri, Robert N Harden

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Abstract

Purpose Oxaliplatin neurotoxicity has a spectrum of manifestations from an often reversible acute neurotoxicity to a more irreversible "stocking and glove" chronic neuropathy that is associated with high morbidity. Quantitative sensory testing (QST) is a noninvasive psychometric testing method that can potentially be used in the clinic setting to measure subclinical neurologic changes early on to identify patients that will experience chronic oxaliplatin-induced peripheral neuropathy at 1 year. Patients and Methods Thirty patients with gastrointestinal malignancies who were receiving oxaliplatin were recruited. QST and patient-reported outcomes were assessed at baseline; during infusion cycles 1, 2, 4, and 6; and at 1 year. National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 4.0, chronic neuropathy scores were assessed at the 1-year time point. The variables at each time point were evaluated for prediction of 1-year chronic neuropathy scores. Results We found that patients with preexisting subclinical neuropathy were more likely to experience grades 2 and 3 chronic neuropathy than were those who did not have this condition (heat detection threshold, Spearman correlation coefficient (rs) = 0.39; P =.037; pellet retrieval time, rs = 0.47; P =.024). Patients in whom thermal and cutaneous sensory deficits developed with cycle 1 infusion were also more likely to experience grades 2 and 3 neuropathy at 1 year (cold detection threshold, rs = 0.50; P =.007; heat detection threshold, rs = 0.39; P =.042; cutaneous detection threshold, rs = 0.42; P =.043). Conclusion QST provides a noninvasive, commercially available, and feasible clinical test to select patients, even before oxaliplatin treatment, who are likely to experience moderate to severe chronic peripheral neuropathy.

Original languageEnglish (US)
Pages (from-to)37-46
Number of pages10
JournalClinical Colorectal Cancer
Volume15
Issue number1
DOIs
StatePublished - Mar 1 2016

Fingerprint

oxaliplatin
Peripheral Nervous System Diseases
Neoplasms
Hot Temperature
Skin
National Cancer Institute (U.S.)
Psychometrics
Terminology
Nervous System

Keywords

  • Colorectal
  • NCI CTCAE
  • Neurooncology
  • Neuropathy
  • Neurotoxicity
  • Oxaliplatin
  • Quantitative sensory testing
  • Thermal

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

@article{0573f8a73f294b799f356bb270220e8d,
title = "Quantitative Sensory Testing at Baseline and during Cycle 1 Oxaliplatin Infusion Detects Subclinical Peripheral Neuropathy and Predicts Clinically Overt Chronic Neuropathy in Gastrointestinal Malignancies",
abstract = "Purpose Oxaliplatin neurotoxicity has a spectrum of manifestations from an often reversible acute neurotoxicity to a more irreversible {"}stocking and glove{"} chronic neuropathy that is associated with high morbidity. Quantitative sensory testing (QST) is a noninvasive psychometric testing method that can potentially be used in the clinic setting to measure subclinical neurologic changes early on to identify patients that will experience chronic oxaliplatin-induced peripheral neuropathy at 1 year. Patients and Methods Thirty patients with gastrointestinal malignancies who were receiving oxaliplatin were recruited. QST and patient-reported outcomes were assessed at baseline; during infusion cycles 1, 2, 4, and 6; and at 1 year. National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 4.0, chronic neuropathy scores were assessed at the 1-year time point. The variables at each time point were evaluated for prediction of 1-year chronic neuropathy scores. Results We found that patients with preexisting subclinical neuropathy were more likely to experience grades 2 and 3 chronic neuropathy than were those who did not have this condition (heat detection threshold, Spearman correlation coefficient (rs) = 0.39; P =.037; pellet retrieval time, rs = 0.47; P =.024). Patients in whom thermal and cutaneous sensory deficits developed with cycle 1 infusion were also more likely to experience grades 2 and 3 neuropathy at 1 year (cold detection threshold, rs = 0.50; P =.007; heat detection threshold, rs = 0.39; P =.042; cutaneous detection threshold, rs = 0.42; P =.043). Conclusion QST provides a noninvasive, commercially available, and feasible clinical test to select patients, even before oxaliplatin treatment, who are likely to experience moderate to severe chronic peripheral neuropathy.",
keywords = "Colorectal, NCI CTCAE, Neurooncology, Neuropathy, Neurotoxicity, Oxaliplatin, Quantitative sensory testing, Thermal",
author = "Reddy, {Sangeetha M.} and Vergo, {Maxwell T.} and Judith Paice and Nancy Kwon and Helenowski, {Irene B.} and {Benson III}, {Al B} and Mulcahy, {Mary Frances} and Nimeiri, {Halla S} and Harden, {Robert N}",
year = "2016",
month = "3",
day = "1",
doi = "10.1016/j.clcc.2015.07.001",
language = "English (US)",
volume = "15",
pages = "37--46",
journal = "Clinical Colorectal Cancer",
issn = "1533-0028",
publisher = "Elsevier",
number = "1",

}

TY - JOUR

T1 - Quantitative Sensory Testing at Baseline and during Cycle 1 Oxaliplatin Infusion Detects Subclinical Peripheral Neuropathy and Predicts Clinically Overt Chronic Neuropathy in Gastrointestinal Malignancies

AU - Reddy, Sangeetha M.

AU - Vergo, Maxwell T.

AU - Paice, Judith

AU - Kwon, Nancy

AU - Helenowski, Irene B.

AU - Benson III, Al B

AU - Mulcahy, Mary Frances

AU - Nimeiri, Halla S

AU - Harden, Robert N

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Purpose Oxaliplatin neurotoxicity has a spectrum of manifestations from an often reversible acute neurotoxicity to a more irreversible "stocking and glove" chronic neuropathy that is associated with high morbidity. Quantitative sensory testing (QST) is a noninvasive psychometric testing method that can potentially be used in the clinic setting to measure subclinical neurologic changes early on to identify patients that will experience chronic oxaliplatin-induced peripheral neuropathy at 1 year. Patients and Methods Thirty patients with gastrointestinal malignancies who were receiving oxaliplatin were recruited. QST and patient-reported outcomes were assessed at baseline; during infusion cycles 1, 2, 4, and 6; and at 1 year. National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 4.0, chronic neuropathy scores were assessed at the 1-year time point. The variables at each time point were evaluated for prediction of 1-year chronic neuropathy scores. Results We found that patients with preexisting subclinical neuropathy were more likely to experience grades 2 and 3 chronic neuropathy than were those who did not have this condition (heat detection threshold, Spearman correlation coefficient (rs) = 0.39; P =.037; pellet retrieval time, rs = 0.47; P =.024). Patients in whom thermal and cutaneous sensory deficits developed with cycle 1 infusion were also more likely to experience grades 2 and 3 neuropathy at 1 year (cold detection threshold, rs = 0.50; P =.007; heat detection threshold, rs = 0.39; P =.042; cutaneous detection threshold, rs = 0.42; P =.043). Conclusion QST provides a noninvasive, commercially available, and feasible clinical test to select patients, even before oxaliplatin treatment, who are likely to experience moderate to severe chronic peripheral neuropathy.

AB - Purpose Oxaliplatin neurotoxicity has a spectrum of manifestations from an often reversible acute neurotoxicity to a more irreversible "stocking and glove" chronic neuropathy that is associated with high morbidity. Quantitative sensory testing (QST) is a noninvasive psychometric testing method that can potentially be used in the clinic setting to measure subclinical neurologic changes early on to identify patients that will experience chronic oxaliplatin-induced peripheral neuropathy at 1 year. Patients and Methods Thirty patients with gastrointestinal malignancies who were receiving oxaliplatin were recruited. QST and patient-reported outcomes were assessed at baseline; during infusion cycles 1, 2, 4, and 6; and at 1 year. National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 4.0, chronic neuropathy scores were assessed at the 1-year time point. The variables at each time point were evaluated for prediction of 1-year chronic neuropathy scores. Results We found that patients with preexisting subclinical neuropathy were more likely to experience grades 2 and 3 chronic neuropathy than were those who did not have this condition (heat detection threshold, Spearman correlation coefficient (rs) = 0.39; P =.037; pellet retrieval time, rs = 0.47; P =.024). Patients in whom thermal and cutaneous sensory deficits developed with cycle 1 infusion were also more likely to experience grades 2 and 3 neuropathy at 1 year (cold detection threshold, rs = 0.50; P =.007; heat detection threshold, rs = 0.39; P =.042; cutaneous detection threshold, rs = 0.42; P =.043). Conclusion QST provides a noninvasive, commercially available, and feasible clinical test to select patients, even before oxaliplatin treatment, who are likely to experience moderate to severe chronic peripheral neuropathy.

KW - Colorectal

KW - NCI CTCAE

KW - Neurooncology

KW - Neuropathy

KW - Neurotoxicity

KW - Oxaliplatin

KW - Quantitative sensory testing

KW - Thermal

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U2 - 10.1016/j.clcc.2015.07.001

DO - 10.1016/j.clcc.2015.07.001

M3 - Article

VL - 15

SP - 37

EP - 46

JO - Clinical Colorectal Cancer

JF - Clinical Colorectal Cancer

SN - 1533-0028

IS - 1

ER -