Chemotherapy induced peripheral neuropathy: the modified total neuropathy score in clinical practice

Ir J Med Sci. 2014 Mar;183(1):53-8. doi: 10.1007/s11845-013-0971-5. Epub 2013 Jul 7.

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, potentially reversible side effect of some chemotherapeutic agents. CIPN is associated with decreased balance, function and quality of life (QoL). This association has to date been under-investigated.

Aims: To profile patients presenting with CIPN using the modified Total Neuropathy Score (mTNS) in this cross-sectional study and to examine the relationship between CIPN (measured by mTNS) and indices of balance, quality of life (QoL) and function.

Methods: Patients receiving neurotoxic chemotherapy regimens were identified using hospital databases. Those who did not have a pre-existing neuropathy were invited to complete mTNS, Berg Balance Scale (BBS), timed up and go (TUG), and FACT-G QoL questionnaire. mTNS scores were profiled and also correlated with BBS, TUG and FACT-G using Spearmans correlation coefficient.

Results: A total of 29 patients undergoing neurotoxic chemotherapy regimens were tested. The patients mTNS scores ranged between 1 and 12 (median = 5), indicating that all patients had clinical evidence of neuropathy on mTNS. No significant correlations were found between mTNS and BERG (r = -0.29), TUG (r = 0.14), or FACT-G (r = 0.05).

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

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Ireland / epidemiology
  • Male
  • Middle Aged
  • Motor Activity / drug effects
  • Neurologic Examination*
  • Neurotoxicity Syndromes / diagnosis*
  • Neurotoxicity Syndromes / epidemiology
  • Peripheral Nervous System Diseases / chemically induced
  • Peripheral Nervous System Diseases / diagnosis*
  • Peripheral Nervous System Diseases / epidemiology
  • Postural Balance / drug effects
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Quality of Life
  • Severity of Illness Index
  • Surveys and Questionnaires*

Substances

  • Antineoplastic Agents