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

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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
Publication statusPublished - Mar 1 2016
Externally publishedYes

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Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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