CIPN represents one of the main dose-limiting and quality of life-affecting factors of taxane therapy in breast cancer patients. Effective therapeutic and prophylactic measures against CIPN are still missing. Aim of this study is to develop a tool, which is capable of evaluating CIPN during chemotherapy and to proof its feasibility in clinical routine.
MEDLINE was searched for detection tools of CIPN. Tools were evaluated according to the following criteria: reliability, validity, objectivity, invasiveness, safety, feasibility in clinical routine and clinical significance of the test results. Outcome measures of the modified QST method were: Thermal detection and pain thresholds and the number of paradoxical heat sensations (with TSA-II-NeuroSensory Analyzer), Mechanical detection threshold (with von Frey hairs 0,25-512mN), Mechanical pain threshold (with pin-prick stimulators 8-512 mN) and Vibration detection threshold (with Rydel–Seiffer graded tuning fork 64 Hz). Ten breast cancer patients under taxane containing chemotherapy were evaluated via the modified QST-Measurement. All patients suffered from CIPN symptoms and had decreased scores in the FACT/GOG-NTx questionnaire.
21 detection tools were identified and evaluated. QST was chosen for conducting the feasibility study. All study patients completed the QST-measurement and were evaluable. QST detected abnormal Z-Values in nine out of ten symptomatic patients (Table).
QST-results H: hand, F:foot, -/ + = values lower/upper from normal z-values, CDT=cold detection threshold, WDT=warm detection threshold, TSL=thermal sensory limen, CPT=cold pain threshold, HPT=heat pain threshold, MPT=mechanical pain threshold, MDT=mechanical detection threshold, VDT=vibration detection threshold, PHS=paradoxical heat sensations.Pat.Nr. CDT WDT TSL CPT HPT MPT MDT VDT PHS H F H F H F H F H F H F H F H F H F 1 – – – – – – 2 3 – – – – – – 1/3 4 – – – 5 + – 6 + + 1/3 7 + – – – – 8 – – – – – + + – – – – 1/3 9 – – – – – – 3/3 10 + + – 2/3
QST is feasible to evaluate CIPN in clinical routine. The modified QST method can be used to evaluate CIPN in breast cancer patients who undergo taxane therapy.
Klinikum Rechts der Isar, Technische Universität München, Dr. med. Johannes Ettl.
Celgene.
All authors have declared no conflicts of interest.