Peripheral Neuropathy Common in Childhood Cancer Survivors
TUESDAY, May 15, 2018 -- Childhood cancer survivors frequently have clinical abnormalities attributable to peripheral neuropathy, according to a study published online May 14 in JAMA Neurology.
Tejaswi Kandula, M.B.B.S., from the University of New South Wales in Sidney, and colleagues recruited cancer survivors who were treated with chemotherapy for extracranial malignancy before age 17 years and compared them with healthy age-matched controls. One hundred sixty-nine patients met the inclusion criteria; 121 childhood cancer survivors underwent neurotoxicity assessments at a median of 8.5 years after completion of treatment and were included in the analyses.
The researchers found that the main neurotoxic agents were vinca alkaloids and platinum compounds. Clinical abnormalities consistent with peripheral neuropathy were common and were observed in about half (50.5 percent) of those treated with neurotoxic chemotherapy (mean Total Neuropathy Score increase, 2.1); these abnormalities correlated with lower limb predominant sensory axonal neuropathy (mean amplitude reduction, 5.8 µV). There were functional deficits in manual dexterity, distal sensation, and balance. An association was seen for patient-reported outcomes demonstrating reduction in global quality of life and physical functioning with the Total Neuropathy Score. Long-term neurotoxicity was more frequently seen with cisplatin than with vinca alkaloids.
"Clinical abnormalities attributable to peripheral neuropathy were common in childhood cancer survivors and persisted long term, with concurrent deficits in patient-reported outcomes," the authors write.
Posted: May 2018