Reactions 1704, p11 - 2 Jun 2018
Peripheral neuropathies common
in childhood cancer survivors
Long-term deficits in measures of chemotherapy-
induced peripheral neuropathy are common in
childhood cancer survivors (CCS), say Australian
They presented results from a cross-sectional
observational study of 121 eligible CCS who received
chemotherapy for extracranial malignancy prior to
17 years of age at Sydney Children’s Hospital were
evaluated, and compared with healthy age-matched
More than 50% of these CCS were males, and
neurotoxicity assessments were conducted in the cohort
at a median age of 16 years (and a median of 8.5 years
after treatment completion).
Vinca alkaloids were the most common type of
neurotoxic chemotherapeutic drug used (>70% of
CCS), with vincristine being the most common sole
agent used (~67% of CCS).
Clinical abnormalities consistent with signs and
symptoms of peripheral neuropathy (assessed by the
Total Neuropathy Score [TNS]) were common (in >50%
Another key finding of this study was that cisplatin-
containing regimens were shown to have a greater
neurotoxicity profile (i.e. TNS >3) versus a vinca
alkaloid-containing regimen (83% vs 29% of CCS)
which was "previously underrecognized in the pediatric
population", stated the researchers.
Neurological findings revealed that the lower limb
sensory amplitudes were smaller in CCS exposed to
neurotoxic chemotherapeutics, compared with controls
(mean amplitude reduction of 5.8µV)
a reduced number of functioning axons.
Functional assessments in child and adolescent CCS
treated with neurotoxic chemotherapeutics revealed
deficiencies in manual dexterity and balance, and that
adult participants experienced impaired performance in
distal sensation and motor tasks.
Finally, patient-reported outcome measures revealed
that participants who received neurotoxic
chemotherapeutics experienced significant reductions
in global quality of life, and physical functioning
correlated with clinical findings (i.e. TNS) for child and
The researchers concluded that "both the type of
neurotoxic agent used and a targeted clinical
neurological assessment are important considerations
when screening CCS for long-term neuropathy".
Kandula T, et al. Chemotherapy-Induced Peripheral Neuropathy in Long-term
Survivors of Childhood Cancer. Clinical, Neurophysiological, Functional, and
Patient-Reported Outcomes. JAMA Neurology : [18 pages], 14 May 2018.
Available from: URL: http://dx.doi.org/10.1001/jamaneurol.2018.0963
Reactions 2 Jun 2018 No. 17040114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved