Assessment Tools for Peripheral Neuropathy in Pediatric Oncology: A Systematic Review From the Children’s Oncology Group

Smolik, S.; Arland, Lesley; Hensley, Mary Ann; Schissel, Debra; Shepperd, Barbara; Thomas, Kristin M.; Rodgers, Cheryl

doi:10.1177/1043454218762705

Cited by 24 publications

(26 citation statements)

References 18 publications

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“…At each hospital uniformly trained assessors evaluated VIPN using two different instruments (CTCAE and ped-mTNS) including standardized physical examination [ 31 ]. Especially the ped-mTNS has been systematically reviewed and is currently recommended for the assessment of VIPN in children [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Vincristine-Induced Peripheral Neuropathy in Pediatric Oncology: A Randomized Controlled Trial Comparing Push Injections with One-Hour Infusions (The VINCA Trial)

Velde

Kaspers

Abbink

et al. 2020

Cancers

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Vincristine (VCR) is a frequently used chemotherapeutic agent. However, it can lead to VCR-induced peripheral neuropathy (VIPN). In this study we investigated if one-hour infusions of VCR instead of push-injections reduces VIPN in pediatric oncology patients. We conducted a multicenter randomized controlled trial in which participants received all VCR administrations through push injections or one-hour infusions. VIPN was measured at baseline and 1–5 times during treatment using Common Terminology Criteria of Adverse Events (CTCAE) and pediatric-modified Total Neuropathy Score. Moreover, data on co-medication, such as azole antifungals, were collected. Overall, results showed no effect of administration duration on total CTCAE score or ped-mTNS score. However, total CTCAE score was significantly lower in patients receiving one-hour infusions concurrently treated with azole antifungal therapy (β = -1.58; p = 0.04). In conclusion, generally VCR administration through one-hour infusions does not lead to less VIPN compared to VCR push injections in pediatric oncology patients. However, one-hour infusions lead to less severe VIPN compared to push-injections when azole therapy is administered concurrently with VCR. These results indicate that in children treated with VCR and requiring concurrent azole therapy, one-hour infusions might be beneficial over push injections, although larger trials are needed to confirm this association.

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Section: Discussionmentioning

confidence: 99%

Vincristine-Induced Peripheral Neuropathy in Pediatric Oncology: A Randomized Controlled Trial Comparing Push Injections with One-Hour Infusions (The VINCA Trial)

Velde

Kaspers

Abbink

et al. 2020

Cancers

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“…Despite certain psychometric limitations, the ped-mTNS is currently considered to be the most optimal instrument for assessing VIPN in children compared with other instruments [37]. Continuous efforts should be made to further improve this instrument, by studying and advancing its reliability and by additionally assessing its validity.…”

Section: Discussionmentioning

confidence: 99%

“…All above-mentioned efforts may result in a more valid and reliable instrument for the assessment of VIPN in children. Meanwhile, using the current version of the ped-mTNS is advocated since it will lead to more uniformity in assessing VIPN in children with cancer, thereby enabling the comparison of study results for this group of patients [37].…”

Section: Discussionmentioning

confidence: 99%

Measuring vincristine-induced peripheral neuropathy in children with cancer: validation of the Dutch pediatric–modified Total Neuropathy Score

Schouten

Velde

Kaspers

et al. 2019

Support Care Cancer

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Purpose The aims were to evaluate the construct validity and reliability of the Dutch version of the pediatric-modified Total Neuropathy Score (ped-mTNS) for assessing vincristine-induced peripheral neuropathy (VIPN) in Dutch pediatric oncology patients aged 5–18 years. Methods Construct validity (primary aim) of the ped-mTNS was determined by testing hypotheses about expected correlation between scores of the ped-mTNS (range: 0–32) and the Common Terminology Criteria for Adverse Events (CTCAE) (range: 0–18) for patients and healthy controls and by comparing patients and controls regarding their total ped-mTNS scores and the proportion of children identified with VIPN. Inter-rater and intra-rater reliability and measurement error (secondary aims) were assessed in a subgroup of study participants. Results Among the 112 children (56 patients and 56 age- and gender-matched healthy controls) evaluated, correlation between CTCAE and ped-mTNS scores was as expected (moderate (r = 0.60)). Moreover, as expected, patients had significantly higher ped-mTNS scores and more frequent symptoms of VIPN compared with controls (both p < .001). Reliability as measured within the intra-rater group (n = 10) (intra-class correlation coefficient (ICCagreement) = 0.64, standard error of measurement (SEMagreement) = 2.92, and smallest detectable change (SDCagreement) = 8.1) and within the inter-rater subgroup (n = 10) (ICCagreement = 0.63, SEMagreement = 3.7, and SDCagreement = 10.26) indicates insufficient reliability. Conclusion The Dutch version of the ped-mTNS appears to have good construct validity for assessing VIPN in a Dutch pediatric oncology population, whereas reliability appears to be insufficient and measurement error high. To improve standardization of VIPN assessment in children, future research aimed at evaluating and further optimizing the psychometric characteristics of the ped-mTNS is needed.

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“…The published literature (Kandula et al, 2016; Mohrmann et al, 2017; Mora et al, 2016; Smolik et al, 2018) provides evidence that pediatric CIPN measurement is challenging, and that no validated CIPN PRO measures have been designed to overcome the assessment challenges. CIPN assessment is particularly difficult when evaluating children < 5 years of age (Lavoie Smith et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Assessment of Pediatric Chemotherapy-Induced Peripheral Neuropathy Using a New Patient-Reported Outcome Measure: The P-CIN

Smith

Kuisell

Kanzawa-Lee

et al. 2020

J Pediatr Oncol Nurs

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Background: Chemotherapy-induced peripheral neuropathy (CIPN) is commonly experienced by children receiving neurotoxic chemotherapy. No validated pediatric CIPN patient-reported outcome (PRO) measures exist. Purpose: To test sensitivity, internal consistency reliability, content and convergent validity, and feasibility of the Pediatric Chemotherapy-Induced Neuropathy (P-CIN), an electronic PRO measure for assessing CIPN in children who received neurotoxic chemotherapy. Method: Five experts evaluated content validity of the 14-item P-CIN. Children 5 to 17 years old with CIPN ( N = 79) completed the P-CIN via tablet computer; a subset ( n = 26) also underwent neurological examinations using the Pediatric–Modified Total Neuropathy Score. Following preliminary analyses, one item was deleted and three others modified. The revised P-CIN was retested with patients ( n = 6) who also completed the Bruininks–Oseretsky Test of Motor Proficiency motor function assessment. Means, item response ranges, standard deviations, content validity indexes, Cronbach’s alphas, and correlation coefficients were calculated. Results: Mean participant age was 11.25 ( SD = 4.0) years. Most had acute leukemia (62.5%) and received vincristine (98.7%). Content validity index coefficients ranged from .80 to 1.0 ( p = .05). For 9 of 14 items, responses ranged from 0 to 4 or 5; response ranges for toe numbness, pick up a coin, and three of four pain items were 0 to 3. After deleting one item, Cronbach’s alpha coefficient was .83. P-CIN scores were strongly associated with Pediatric-Modified Total Neuropathy Score ( r = .52, p < .01) and Bruininks–Oseretsky Test of Motor Proficiency ( r = −.83, p = .04) scores. Sixty-eight percent of children 6 to 17 years old completed P-CIN independently. Discussion: Preliminary evidence suggests that the 13-item P-CIN is internally consistent, is valid, and can be completed independently by children ≥ 6 years. However, we recommend additional testing.

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Assessment Tools for Peripheral Neuropathy in Pediatric Oncology: A Systematic Review From the Children’s Oncology Group

Cited by 24 publications

References 18 publications

Vincristine-Induced Peripheral Neuropathy in Pediatric Oncology: A Randomized Controlled Trial Comparing Push Injections with One-Hour Infusions (The VINCA Trial)

Vincristine-Induced Peripheral Neuropathy in Pediatric Oncology: A Randomized Controlled Trial Comparing Push Injections with One-Hour Infusions (The VINCA Trial)

Measuring vincristine-induced peripheral neuropathy in children with cancer: validation of the Dutch pediatric–modified Total Neuropathy Score

Assessment of Pediatric Chemotherapy-Induced Peripheral Neuropathy Using a New Patient-Reported Outcome Measure: The P-CIN

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