Prechemotherapy Touch Sensation Deficits Predict Oxaliplatin Induced Neuropathy in Patients with Colorectal Cancer
Objective: We examined the emergence of chemotherapy induced peripheral neuropathy (CIPN) a dose limiting toxicity of oxaliplatin, over the course of oxaliplatin based chemotherapy for colorectal cancer (CRC) Predicting which patients will likely develop CIPN is an ongoing clinical challenge. Methods: Oxaliplatin naive patients with CRC underwent quantitative sensory testing (QST) before beginning oxaliplatin based chemotherapy and then rated CIPN related symptoms via the MD Anderson Symptom Inventory (MDASI) weekly for 26 weeks. Mixed modeling examined the value of QST for predicting higher CIPN (MDASI numbness/tingling) during treatment. Trajectory analysis identified a patient subgroup with consistently higher CIPN symptoms. Results: Numbness/tingling was the most frequent, most severe symptom, with 51% of patients clustering into a high CIPN subgroup. Touch sensation deficits (Bumps Detection test) significantly predicted the development of more severe numbness/tingling [estimate (est) 0.106, p 0.0003] The high CIPN subgroup reported increased pain (est 0.472, p 0.0001) and interference with walking (est 0.840, p 0.0001) In the high CIPN subgroup, patient reported numbness/tingling worsened rapidly in weeks 0 5 (est 0.57, p 0.0001) and then more gradually in weeks 6 26 (est 0.07, p 0.0001) Conclusion: Prechemotherapy screening with a simple, easily administered objective measure of touch sensation deficits (Bumps Detection test) and monitoring of patient reported numbness/tingling during the first 2 3 chemotherapy cycles may support improved personalized care of CRC patients with oxaliplatin induced CIPN.
Oncology