Clinical application of the PainVision system for quantitative assessment of chemotherapy-induced peripheral neuropathy.

Abstract

e24038 Background: Chemotherapy is one of the important methods of anti-tumor treatment at present. It brings disease remission along with various adverse events. Peripheral neurotoxicity is one of the adverse events caused by chemotherapy and is usually caused by drugs such as oxaliplatin or paclitaxel. Peripheral neuropathy is not fatal disease, but it seriously affects the patient's quality of life. Methods: In this study, we tried the neurotic electrophysiologic method by way of PainVision system to evaluate the current of perception threshold (CPT) of patients who were about to receive or were receiving chemotherapy with oxaliplatin or paclitaxel. The detection site is the inner side of the forearm , or the limbs where numbness is obvious. During the subsequent treatment, the CPT levels were continuously monitored and the CPT levels of the same detection site were compared. Patients with concurrent central nervous system lesions were excluded. Results: The results showed that among the 78 patients who participated in the monitoring, 36 patients did not endure obvious neurotoxic symptoms such as numbness or pain, and their CPT levels did not change significantly. The remaining 42 patients felt varying degrees of peripheral neurotoxicity, manifested as numbness or pain in the hands and feet, and poor activity. Among them, 20 patients experienced gradually worsened symptoms following the increased cycles of treatments, and the CPT level also increased. Among them, 14 patients changed treatment regimens due to disease progression and discontinued the use of relevant drugs. The CPT level no longer increased, but it did not decrease significantly in the short term.The patients who discontinued the related drugs for more than 6 months showed a decrease of CPT but no statistical significance. Conclusions: The PainVision system is designed to carry out quantitatively assessment of pain. This study used it to quantitatively assess peripheral neuropathy caused by chemotherapy drugs, which initially reflected the feasibility of clinical application and provided a quantitative basis for assessment of lesion severity and treatment efficacy. The CPT level of patients with or without peripheral neuropathy symptoms. Peripheral Neuropathy Symptoms N CPT (mean ± sd , μA) p value No 36 Before Therapy 17.65 ± 4.58 After Therapy 18.80 ± 3.13 p =0.074 Yes 42 N/A 25.73 ± 10.64 p <0.01 * Washout Period N/A 28 N/A 26.99 ± 11.73 < 6 Months 9 N/A 24.4 ± 7.89 p= 0.534 * > 6 Months 5 N/A 19.65±6.90 p= 0.348 * * Compared with the patients after therapy but without symptoms. ** Compared with the patients still receiving related drugs.