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 A. Paice, Nancy Kwon, Irene B. Helenowski, Al B. Benson, Mary F. Mulcahy, Halla S. Nimeiri, Robert N. Harden

*Corresponding author for this work

Research output: Contribution to journalArticle

15 Scopus citations

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

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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