Abstract

To test if and how chemotherapy-induced peripheral neurotoxicity (CIPN) is perceived differently by patients and physicians, making assessment and interpretation challenging. We performed a secondary analysis of the CI-PeriNomS study which included 281 patients with stable CIPN. We tested: (a) the association between patients' perception of activity limitation in performing eight common tasks and neurological impairment and (b) how the responses to questions related to these daily activities are interpreted by the treating oncologist. To achieve this, we compared patients' perception of their activity limitation with neurological assessment and the oncologists' blind interpretation. Distribution of the scores attributed by oncologists to each daily life maximum limitation (“impossible”) generated three groups: Group 1 included limitations oncologists attributed mainly to motor impairment; Group 2 ones mainly attributed to sensory impairment and Group 3 ones with uncertain motor and sensory impairment. Only a subset of questions showed a significant trend between severity in subjective limitation, reported by patients, and neurological impairment. In Group 1, neurological examination confirmed motor impairment in only 51%-65% of patients; 76%-78% of them also had vibration perception impairment. In Group 2, sensory impairment ranged from 84% to 100%; some degree of motor impairment occurred in 43%-56% of them. In Group 3 strength reduction was observed in 49%-50% and sensory perception was altered in up to 82%. Interpretation provided by the panel of experienced oncologists was inconsistent with the neurological impairment. These observations highlight the need of a core set of outcome measures for future CIPN trials.

Original languageEnglish
JournalJournal of the Peripheral Nervous System
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Physicians
Drug Therapy
Neurologic Examination
Vibration
Outcome Assessment (Health Care)
Oncologists

Keywords

  • assessment
  • chemotherapy
  • neurotoxicity
  • patient reported outcome measures
  • side effects

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

Cite this

Patients' and physicians' interpretation of chemotherapy-induced peripheral neurotoxicity. / the CI-PeriNomS Group.

In: Journal of the Peripheral Nervous System, 01.01.2019.

Research output: Contribution to journalArticle

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title = "Patients' and physicians' interpretation of chemotherapy-induced peripheral neurotoxicity",
abstract = "To test if and how chemotherapy-induced peripheral neurotoxicity (CIPN) is perceived differently by patients and physicians, making assessment and interpretation challenging. We performed a secondary analysis of the CI-PeriNomS study which included 281 patients with stable CIPN. We tested: (a) the association between patients' perception of activity limitation in performing eight common tasks and neurological impairment and (b) how the responses to questions related to these daily activities are interpreted by the treating oncologist. To achieve this, we compared patients' perception of their activity limitation with neurological assessment and the oncologists' blind interpretation. Distribution of the scores attributed by oncologists to each daily life maximum limitation (“impossible”) generated three groups: Group 1 included limitations oncologists attributed mainly to motor impairment; Group 2 ones mainly attributed to sensory impairment and Group 3 ones with uncertain motor and sensory impairment. Only a subset of questions showed a significant trend between severity in subjective limitation, reported by patients, and neurological impairment. In Group 1, neurological examination confirmed motor impairment in only 51{\%}-65{\%} of patients; 76{\%}-78{\%} of them also had vibration perception impairment. In Group 2, sensory impairment ranged from 84{\%} to 100{\%}; some degree of motor impairment occurred in 43{\%}-56{\%} of them. In Group 3 strength reduction was observed in 49{\%}-50{\%} and sensory perception was altered in up to 82{\%}. Interpretation provided by the panel of experienced oncologists was inconsistent with the neurological impairment. These observations highlight the need of a core set of outcome measures for future CIPN trials.",
keywords = "assessment, chemotherapy, neurotoxicity, patient reported outcome measures, side effects",
author = "{the CI-PeriNomS Group} and Guido Cavaletti and Cornblath, {David R.} and Merkies, {Ingemar S.J.} and Postma, {Tjeerd J.} and Emanela Rossi and Paola Alberti and Jordi Bruna and Argyriou, {Andreas A.} and Chiara Briani and Roser Velasco and Kalofonos, {Haralabos P.} and Dimitri Psimaras and Damien Ricard and Andrea Pace and Faber, {Catharina G.} and Lalisang, {Roy I.} and Dieta Brandsma and Susanne Koeppen and Simon Kerrigan and Angelo Schenone and Wolfgang Grisold and Anna Mazzeo and Luca Padua and Dorsey, {Susan G.} and Marta Penas-Prado and Valsecchi, {Maria G.} and Guido Cavaletti and Cornblath, {David R.} and Merkies, {Ingemar S.J.} and Postma, {Tjeerd J.} and Emanela Rossi and Paola Alberti and Jordi Bruna and Argyriou, {Andreas A.} and Chiara Briani and Roser Velasco and Kalofonos, {Haralabos P.} and Dimitri Psimaras and Damien Ricard and Andrea Pace and Faber, {Catharina G.} and Lalisang, {Roy I.} and Angelo Schenone and Luca Padua and Marina Cazzaniga and Edvina Gali{\`e} and Giuseppe Granata and Rosaria Plasmati and Antonio Toscano and Mariacarmela Santarpia",
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month = "1",
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language = "English",
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AU - the CI-PeriNomS Group

AU - Cavaletti, Guido

AU - Cornblath, David R.

AU - Merkies, Ingemar S.J.

AU - Postma, Tjeerd J.

AU - Rossi, Emanela

AU - Alberti, Paola

AU - Bruna, Jordi

AU - Argyriou, Andreas A.

AU - Briani, Chiara

AU - Velasco, Roser

AU - Kalofonos, Haralabos P.

AU - Psimaras, Dimitri

AU - Ricard, Damien

AU - Pace, Andrea

AU - Faber, Catharina G.

AU - Lalisang, Roy I.

AU - Brandsma, Dieta

AU - Koeppen, Susanne

AU - Kerrigan, Simon

AU - Schenone, Angelo

AU - Grisold, Wolfgang

AU - Mazzeo, Anna

AU - Padua, Luca

AU - Dorsey, Susan G.

AU - Penas-Prado, Marta

AU - Valsecchi, Maria G.

AU - Cavaletti, Guido

AU - Cornblath, David R.

AU - Merkies, Ingemar S.J.

AU - Postma, Tjeerd J.

AU - Rossi, Emanela

AU - Alberti, Paola

AU - Bruna, Jordi

AU - Argyriou, Andreas A.

AU - Briani, Chiara

AU - Velasco, Roser

AU - Kalofonos, Haralabos P.

AU - Psimaras, Dimitri

AU - Ricard, Damien

AU - Pace, Andrea

AU - Faber, Catharina G.

AU - Lalisang, Roy I.

AU - Schenone, Angelo

AU - Padua, Luca

AU - Cazzaniga, Marina

AU - Galiè, Edvina

AU - Granata, Giuseppe

AU - Plasmati, Rosaria

AU - Toscano, Antonio

AU - Santarpia, Mariacarmela

PY - 2019/1/1

Y1 - 2019/1/1

N2 - To test if and how chemotherapy-induced peripheral neurotoxicity (CIPN) is perceived differently by patients and physicians, making assessment and interpretation challenging. We performed a secondary analysis of the CI-PeriNomS study which included 281 patients with stable CIPN. We tested: (a) the association between patients' perception of activity limitation in performing eight common tasks and neurological impairment and (b) how the responses to questions related to these daily activities are interpreted by the treating oncologist. To achieve this, we compared patients' perception of their activity limitation with neurological assessment and the oncologists' blind interpretation. Distribution of the scores attributed by oncologists to each daily life maximum limitation (“impossible”) generated three groups: Group 1 included limitations oncologists attributed mainly to motor impairment; Group 2 ones mainly attributed to sensory impairment and Group 3 ones with uncertain motor and sensory impairment. Only a subset of questions showed a significant trend between severity in subjective limitation, reported by patients, and neurological impairment. In Group 1, neurological examination confirmed motor impairment in only 51%-65% of patients; 76%-78% of them also had vibration perception impairment. In Group 2, sensory impairment ranged from 84% to 100%; some degree of motor impairment occurred in 43%-56% of them. In Group 3 strength reduction was observed in 49%-50% and sensory perception was altered in up to 82%. Interpretation provided by the panel of experienced oncologists was inconsistent with the neurological impairment. These observations highlight the need of a core set of outcome measures for future CIPN trials.

AB - To test if and how chemotherapy-induced peripheral neurotoxicity (CIPN) is perceived differently by patients and physicians, making assessment and interpretation challenging. We performed a secondary analysis of the CI-PeriNomS study which included 281 patients with stable CIPN. We tested: (a) the association between patients' perception of activity limitation in performing eight common tasks and neurological impairment and (b) how the responses to questions related to these daily activities are interpreted by the treating oncologist. To achieve this, we compared patients' perception of their activity limitation with neurological assessment and the oncologists' blind interpretation. Distribution of the scores attributed by oncologists to each daily life maximum limitation (“impossible”) generated three groups: Group 1 included limitations oncologists attributed mainly to motor impairment; Group 2 ones mainly attributed to sensory impairment and Group 3 ones with uncertain motor and sensory impairment. Only a subset of questions showed a significant trend between severity in subjective limitation, reported by patients, and neurological impairment. In Group 1, neurological examination confirmed motor impairment in only 51%-65% of patients; 76%-78% of them also had vibration perception impairment. In Group 2, sensory impairment ranged from 84% to 100%; some degree of motor impairment occurred in 43%-56% of them. In Group 3 strength reduction was observed in 49%-50% and sensory perception was altered in up to 82%. Interpretation provided by the panel of experienced oncologists was inconsistent with the neurological impairment. These observations highlight the need of a core set of outcome measures for future CIPN trials.

KW - assessment

KW - chemotherapy

KW - neurotoxicity

KW - patient reported outcome measures

KW - side effects

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