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

Schouten, Stijn; Velde, Mirjam E. van de; Kaspers, Gertjan J. L.; Mokkink, Lidwine B.; Sluis, Inge M. van der; Bos, Cor van den; Hartman, Annelies; Abbink, Floor; Berg, Marleen H van den

doi:10.1007/s00520-019-05106-3

Cited by 16 publications

(18 citation statements)

References 26 publications

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“…Secondary endpoints of the current study included VIPN measured by the Dutch version of the ped-mTNS [ 31 , 52 ] and by the use of specific analgesics for neuropathic pain. The ped-mTNS is a validated instrument, including a questionnaire (sensory, functional and autonomic symptoms) and physical examination, developed to assess VIPN in children aged ≥ 5 years.…”

Section: Methodsmentioning

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: Methodsmentioning

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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“…In addition, the ped‐mTNS (Dutch translation) was used for VIPN assessment. 30 This validated instrument for assessing VIPN in children includes a questionnaire (functional, sensory, and autonomic symptoms) and a physical examination. It can be used for VIPN assessment in pediatric patients aged 5 years or older.…”

Section: Methodsmentioning

confidence: 99%

The association between vincristine‐induced peripheral neuropathy and health‐related quality of life in children with cancer

et al. 2021

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PurposeVincristine (VCR) is a chemotherapeutic agent used in the treatment of pediatric oncology patients, but its main toxicity is VCR‐induced peripheral neuropathy (VIPN). However, whether VIPN has an effect on health‐related quality of life (HR‐QoL) in children during treatment is unknown. Therefore, the aim of our study was to investigate the association between VIPN and HR‐QoL in children starting treatment for cancer.MethodsMeasurements of VIPN were performed using two tools: Common Terminology Criteria for Adverse Events (CTCAE) and pediatric‐modified Total Neuropathy Score (ped‐mTNS). Assessment of HR‐QoL was done with self‐ and proxy assessment of the Cancer and Generic module of the Pediatric Cancer Quality of Life Inventory™ (PedsQL).ResultsIn total, N = 86 children were included. HR‐QoL of children with VIPN (n = 67%, 76%) was significantly lower in comparison with children without VIPN: estimated Total score of PedsQL Generic (proxy) 84.57; β = −8.96 and 95% confidence interval (CI) −14.48 to −3.43; p = 0.002, estimated PedsQL Generic Total score (self‐reported): 85.16, β = −8.38 (95% CI: −13.76 to −3.00); p = 0.003. Similar results were found in the Pain and Hurt domain of the PedsQL Cancer (pain: estimated score [proxy]: 85.28, β = −9.94 [95%CI: −16.44 to −3.45], p = 0.003; hurt: estimated score [self‐report] 97.57, β = −19.15 [95%CI: −26.82 to −11.48], p < 0.001).ConclusionVIPN results in a significant reduction of HR‐QoL in children under treatment for a malignancy, which means that VIPN is important for the well‐being of pediatric oncology patients. Therefore, this study underlines the importance of optimizing treatment with VCR, thereby aiming to reduce VIPN while maintaining efficacy.

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“…The pediatric-modified Total Neuropathy Score (ped-mTNS) was introduced in 2009, consisting of an interview-based questionnaire and physical examination [11]. This tool has been validated in different languages, recently in a Dutch pediatric oncology population that included children with ALL [12]. The ped-mTNS contains eight questions about sensory, functional, and autonomic symptoms.…”

Section: Pain Assessment In Childrenmentioning

confidence: 99%

Pain Management in Childhood Leukemia: Diagnosis and Available Analgesic Treatments

Coluzzi

Rocco

Gladden

et al. 2020

Cancers

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Pain is one of the most common symptoms in children suffering from leukemia, who are often misdiagnosed with other childhood painful diseases such as juvenile idiopathic arthritis. Corticosteroid-induced osteonecrosis (ON) and vincristine-induced peripheral neuropathy (VIPN) are the most common painful manifestations. Additionally, ongoing pain may continue to impact quality of life in survivorship. This narrative review focuses on the pathophysiological mechanisms of pain in childhood leukemia and current available indications for analgesic treatments. Pain management in children is often inadequate because of difficulties in pain assessment, different indications across countries, and the lack of specific pediatric trials. Analgesic drugs are often prescribed off-label to children by extrapolating information from adult guidelines, with possible increased risk of adverse events. Optimal pain management should involve a multidisciplinary team to ensure assessment and interventions tailored to the individual patient.

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

Cited by 16 publications

References 26 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)

The association between vincristine‐induced peripheral neuropathy and health‐related quality of life in children with cancer

Pain Management in Childhood Leukemia: Diagnosis and Available Analgesic Treatments

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