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

Abstract

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.

Vincristine and Peripheral Neuropathy in Acute Lymphoblastic Leukemia Children

“…The frequency of peripheral neuropathy in pediatric ALL patients in this study (5.07%) was lower than in previous study, with the India study being 13.8% of completed remission patient 12 and the Netherlands study having 82% 11 . The vincristine-induced peripheral neuropathy (VIPN) score; such as the pediatric modified total neuropathy score (ped-mTNS) was neither applied or reported in our this study due to the context of age in some patients 4 .…”

“…Chemotherapy-induced peripheral neuropathy is diagnosed by abnormalities of history, physical examination, and nerve electrophysiology 1,4 . Peripheral neuropathy not only affects the patient's quality of life but also leads to decrease the vincristine dose, which could affect the overall survival of the patient 11 .…”

A bibliometric analysis of chemotherapy and pain in pediatric patients over the last decade

“…The main toxicity of VCR is VIPN, which can significantly reduce health-related QoL (HR-QoL), including Pain and Hurt domain of Pediatric Cancer Quality of Life Inventory™ (PedsQL). CIPN has a significant influence on the health of pediatric patients ( 26 ). This study is the first study that used the bibliometric method and visual information technology to reveal major research hotspots in chemotherapy and pain among pediatric patients with cancer.…”

Chemotherapy-Induced Peripheral Neuropathy Leading to Foot Deformity

“…CIPN prevalence has been shown to be highest (68.1%) within the first month after treatment cessation, and gradually reduces to 60.0% after 3 months, and 30.0% after 6 months or more 8 . Risk factors for developing CIPNs have been thoroughly investigated, with many studies finding greater propensity among older children ($10 years of age), children diagnosed with Charcot-Marie-Tooth disease, Caucasians, and those undergoing treatment for fungal infections [8][9][10][11] . Unfortunately, there are currently no treatment options to prevent or minimize the prevalence of CIPN in patients.…”