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 researchers. 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 controls. 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% of CCS). 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) – which suggested 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 – which correlated with clinical findings (i.e. TNS) for child and adolescent CCS. 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 803324372 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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