Skip to main content

Advertisement

SpringerLink
Log in

Characterization of chemotherapy-induced peripheral neuropathy using patient-reported outcomes and quantitative sensory testing

  • Clinical trial
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Chemotherapy-induced peripheral neuropathy (CIPN) is a common, debilitating side effect in cancer survivors. This study aimed to assess the characteristics of quantitative sensory testing (QST) and its correlation with patient-reported outcomes (PROs) in cancer patients with and without CIPN.

Methods

We conducted a cross-sectional analysis using baseline data from two clinical trials in solid tumor cancer survivors with no CIPN symptoms rated < 2 on a 0–10 Numerical Rating Scale (NRS) or moderate-to-severe CIPN rated ≥ 4 on the NRS. We collected PROs (NRS, Neuropathic Pain Scale, and Functional Assessment of Cancer Therapy-Gynecologic Oncology Group/Neurotoxicity subscale at baseline. QST [Tactile Threshold (TT), Vibration Threshold (VT), Thermal Threshold (THT)] measurements were used to assess sensory fiber function; they were compared between patients with and without CIPN using Wilcoxon rank-sum tests. We used Spearman correlation coefficients to estimate associations between PROs and QST in all patients.

Results

Among 116 participants with CIPN (median NRS 5.00) and 10 participants without CIPN (median NRS 0.00), the median (interquartile range) TT was 3.84 (3.47, 4.12) and 3.53 (3.00, 3.84) in feet, respectively (p = 0.043). The median VT was 17.90 (9.42, 26.95) and 7.73 (5.94, 11.11) in feet, respectively (p = 0.001). Thermal cool threshold was 30.00 °C (28.90, 30.57) and 30.67 °C (30.57, 30.93), respectively (p = 0.007). Correlation coefficients between PROs and QST measures ranged between 0.02 and 0.50 in absolute magnitude.

Conclusion

Patients with moderate-to-severe CIPN had significantly impaired tactile, vibratory, and thermal thresholds compared to patients without CIPN. QST correlates with PROs, suggesting CIPN symptom severity may correspond to sensory fiber functionality. QST may be incorporated into future CIPN research.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Schneider BP, Hershman DL, Loprinzi C (2015) Symptoms: chemotherapy-induced peripheral neuropathy. Adv Exp Med Biol 862:77–87. https://doi.org/10.1007/978-3-319-16366-6_6

    Article  PubMed  Google Scholar 

  2. Ewertz M, Qvortrup C, Eckhoff L (2015) Chemotherapy-induced peripheral neuropathy in patients treated with taxanes and platinum derivatives. Acta Oncol 54(5):587–591. https://doi.org/10.3109/0284186X.2014.995775

    Article  PubMed  CAS  Google Scholar 

  3. Seretny M, Currie GL, Sena ES, Ramnarine S, Grant R, MacLeod MR, Colvin LA, Fallon M (2014) Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis. Pain 155(12):2461–2470. https://doi.org/10.1016/j.pain.2014.09.020

    Article  PubMed  Google Scholar 

  4. Pachman DR, Barton DL, Watson JC, Loprinzi CL (2011) Chemotherapy-induced peripheral neuropathy: prevention and treatment. Clin Pharmacol Ther 90(3):377–387. https://doi.org/10.1038/clpt.2011.115

    Article  PubMed  CAS  Google Scholar 

  5. Mols F, Beijers T, Lemmens V, van den Hurk CJ, Vreugdenhil G, van de Poll-Franse LV (2013) Chemotherapy-induced neuropathy and its association with quality of life among 2- to 11-year colorectal cancer survivors: results from the population-based PROFILES registry. J Clin Oncol 31(21):2699–2707. https://doi.org/10.1200/JCO.2013.49.1514

    Article  PubMed  Google Scholar 

  6. Backonja MM, Attal N, Baron R, Bouhassira D, Drangholt M, Dyck PJ, Edwards RR, Freeman R, Gracely R, Haanpaa MH, Hansson P, Hatem SM, Krumova EK, Jensen TS, Maier C, Mick G, Rice AS, Rolke R, Treede RD, Serra J, Toelle T, Tugnoli V, Walk D, Walalce MS, Ware M, Yarnitsky D, Ziegler D (2013) Value of quantitative sensory testing in neurological and pain disorders: NeuPSIG consensus. Pain 154(9):1807–1819. https://doi.org/10.1016/j.pain.2013.05.047

    Article  PubMed  Google Scholar 

  7. Wang XS, Shi Q, Dougherty PM, Eng C, Mendoza TR, Williams LA, Fogelman DR, Cleeland CS (2016) Prechemotherapy touch sensation deficits predict oxaliplatin-induced neuropathy in patients with colorectal cancer. Oncology 90(3):127–135. https://doi.org/10.1159/000443377

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Gordon-Williams R, Farquhar-Smith P (2020) Recent advances in understanding chemotherapy-induced peripheral neuropathy. F1000Research. https://doi.org/10.12688/f1000research.21625.1

    Article  PubMed  PubMed Central  Google Scholar 

  9. Bao T, Zhi I, Baser R, Hooper M, Chen C, Piulson L, Li QS, Galantino ML, Blinder V, Robson M, Seidman A, Panageas KS, Mao JJ (2020) Yoga for chemotherapy-induced peripheral neuropathy and fall risk: a randomized controlled trial. JNCI Cancer Spectrum. https://doi.org/10.1093/jncics/pkaa048

    Article  PubMed  PubMed Central  Google Scholar 

  10. Bao T, Patil S, Chen C, Zhi IW, Li QS, Piulson L, Mao JJ (2020) Effect of acupuncture vs sham procedure on chemotherapy-induced peripheral neuropathy symptoms: a randomized clinical trial. JAMA Netw Open 3(3):e200681. https://doi.org/10.1001/jamanetworkopen.2020.0681

    Article  PubMed  PubMed Central  Google Scholar 

  11. Zhi WI, Chen P, Kwon A, Chen C, Harte SE, Piulson L, Li S, Patil S, Mao JJ, Bao T (2019) Chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer survivors: a comparison of patient-reported outcomes and quantitative sensory testing. Breast Cancer Res Treat 178(3):587–595. https://doi.org/10.1007/s10549-019-05416-4

    Article  PubMed  PubMed Central  Google Scholar 

  12. Childs JD, Piva SR, Fritz JM (2005) Responsiveness of the numeric pain rating scale in patients with low back pain. Spine 30(11):1331–1334

    Article  Google Scholar 

  13. Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM (2001) Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 94(2):149–158

    Article  Google Scholar 

  14. Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA, Anderson JA (1978) Studies with pain rating scales. Annals Rheum Dis 37(4):378–381

    Article  CAS  Google Scholar 

  15. Ferraz MB, Quaresma MR, Aquino LR, Atra E, Tugwell P, Goldsmith CH (1990) Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis. J Rheumatol 17(8):1022–1024

    PubMed  CAS  Google Scholar 

  16. Jensen MP, Friedman M, Bonzo D, Richards P (2006) The validity of the neuropathic pain scale for assessing diabetic neuropathic pain in a clinical trial. Clin J Pain 22(1):97–103. https://doi.org/10.1097/01.ajp.0000173018.64741.62

    Article  PubMed  Google Scholar 

  17. Galer BS, Jensen MP (1997) Development and preliminary validation of a pain measure specific to neuropathic pain: the Neuropathic Pain Scale. Neurology 48(2):332–338. https://doi.org/10.1212/wnl.48.2.332

    Article  PubMed  CAS  Google Scholar 

  18. Drobek W, De Laat A, Schoenaers J (2001) Tactile threshold and pressure pain threshold during treatment of orofacial pain: an explorative study. Clin Oral Investig 5(3):185–193

    Article  CAS  Google Scholar 

  19. North Coast Medical I (2011) Touch test sensory evaluator brochure. https://www.ncmedical.com/wp-content/uploads/2011/07/Touch-Test-Sensory-Evaluator_11_web.pdf. Accessed 3 2020

  20. Goldberg JM, Lindblom U (1979) Standardised method of determining vibratory perception thresholds for diagnosis and screening in neurological investigation. J Neurol Neurosurg Psychiatry 42(9):793–803

    Article  CAS  Google Scholar 

  21. Company B-MI Bio-Thesiometer Instructions for Operation. http://www.biothesiometer.com/. Accessed 2 2020

  22. Boyette-Davis JA, Eng C, Wang XS, Cleeland CS, Wendelschafer-Crabb G, Kennedy WR, Simone DA, Zhang H, Dougherty PM (2012) Subclinical peripheral neuropathy is a common finding in colorectal cancer patients prior to chemotherapy. Clin Cancer Res 18(11):3180–3187. https://doi.org/10.1158/1078-0432.CCR-12-0205

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Augusto C, Pietro M, Cinzia M, Sergio C, Sara C, Luca G, Scaioli V (2008) Peripheral neuropathy due to paclitaxel: study of the temporal relationships between the therapeutic schedule and the clinical quantitative score (QST) and comparison with neurophysiological findings. J Neurooncol 86(1):89–99. https://doi.org/10.1007/s11060-007-9438-8

    Article  PubMed  CAS  Google Scholar 

  24. Dougherty PM, Cata JP, Cordella JV, Burton A, Weng HR (2004) Taxol-induced sensory disturbance is characterized by preferential impairment of myelinated fiber function in cancer patients. Pain 109(1–2):132–142. https://doi.org/10.1016/j.pain.2004.01.021

    Article  PubMed  CAS  Google Scholar 

  25. Hershman DL, Weimer LH, Wang A, Kranwinkel G, Brafman L, Fuentes D, Awad D, Crew KD (2011) Association between patient reported outcomes and quantitative sensory tests for measuring long-term neurotoxicity in breast cancer survivors treated with adjuvant paclitaxel chemotherapy. Breast Cancer Res Treat 125(3):767–774. https://doi.org/10.1007/s10549-010-1278-0

    Article  PubMed  CAS  Google Scholar 

  26. Staff NP, Grisold A, Grisold W, Windebank AJ (2017) Chemotherapy-induced peripheral neuropathy: a current review. Ann Neurol 81(6):772–781. https://doi.org/10.1002/ana.24951

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  27. Roldan CJ, Johnson C, Lee SO, Peng A, Dougherty PM, Huh B (2018) Subclinical peripheral neuropathy in patients with head and neck cancer: a quantitative sensory testing (QST) study. Pain Physician 21(4):E419–E427

    Article  Google Scholar 

Download references

Funding

This manuscript is supported in part by a grant from the National Institutes of Health/National Cancer Institute Cancer Center (P30 CA008748) and the Translational and Integrative Medicine Research Fund at Memorial Sloan Kettering Cancer Center.

Author information

Authors and Affiliations

  1. Breast Medicine Service, Solid Tumor Division, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    W. Iris Zhi

  2. Department of Epidemiology and Biostatistics, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Raymond E. Baser & Katherine S. Panageas

  3. Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, USA

    Alice Kwon

  4. New York University Winthrop Hospital, New York, NY, USA

    Connie Chen

  5. Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Susan Qing Li, Lauren Piulson, Christina Seluzicki, Jun J. Mao & Ting Bao

  6. Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA

    Steven E. Harte

  7. Bendheim Integrative Medicine Center, 1429 First Avenue, New York, NY, 10021, USA

    Ting Bao

Authors
  1. W. Iris Zhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Raymond E. Baser
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alice Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Connie Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Susan Qing Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lauren Piulson
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Christina Seluzicki
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Katherine S. Panageas
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Steven E. Harte
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jun J. Mao
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Ting Bao
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

WIZ: conceptualization, formal analysis, investigation, methodology, validation, writing—original draft, writing—review and editing. REB: conceptualization, formal analysis, investigation, methodology, writing—original draft, writing—review and editing. AK: investigation, writing—review and editing. CC: investigation, writing—review and editing. SQL: data curation, investigation, software, writing—review and editing. LP: data curation, investigation, project administration, writing—review and editing. CS: investigation, writing—review and editing. KSP: conceptualization, investigation, writing—review and editing. SEH: investigation, writing—review and editing. JJM: investigation, resources, writing—review and editing. TB: conceptualization, formal analysis, funding acquisition, investigation, methodology, resources, supervision, validation, writing—original draft, writing—review and editing.

Corresponding author

Correspondence to Ting Bao.

Ethics declarations

Conflict of interest

Dr. Mao reports grants from Tibet Cheezheng Tibetan Medicine Co., Ltd. and from Zhongke Health International, LLC outside the submitted work. Dr. Harte reports grants and personal fees from Aptinyx, and grants and other from Arbor Medical Innovations, outside the submitted work. In addition, Dr. Harte has a patent US9307906 licensed. Dr. Panageas reports other from Johnson and Johnson, Pfizer, Viking Therapeutics, and Catalyst Biotech, outside the submitted work. All other authors report no potential conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhi, W.I., Baser, R.E., Kwon, A. et al. Characterization of chemotherapy-induced peripheral neuropathy using patient-reported outcomes and quantitative sensory testing. Breast Cancer Res Treat 186, 761–768 (2021). https://doi.org/10.1007/s10549-020-06079-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-020-06079-2

Keywords

Search

Navigation