Diagnostic tools should be used for the diagnosis of chemotherapy induced peripheral neuropathy in breast cancer patients receiving taxanes

BACKGROUND: Though the incidence, characteristics, and pathogenesis of chemotherapy induced peripheral neuropathy (CIPN) by taxane based chemotherapy were extensively studied, diagnostic guidelines extent only recently.

AIM: To observationally investigate whether specific tests can be used to predict and monitor CIPN severity.

METHODS: Fourteen female breast cancer patients receiving paclitaxel or docetaxel were evaluated using the McGill Pain Questionnaire (MPQ), National Cancer Institute Common Toxicity Criteria (NCI-CTC) grading, clinical total neuropathy score (TNSc), quantitative sensory testing (QST) of pressure pain threshold (PPT), and numeric rating scale (NRS) scores and stocking and glove distribution testing (SGDT), at the start (T0), midst (T1), and end (T2) of their treatment and after 3 months (T3).

RESULTS: At T3, patients scored NCI-CTC neuropathy grade 1 (14.3%), 2 (64.3%), and 3 (14.3%) respectively. Fifty percentage scored at least grade 1 at T0, with complaints not caused by CIPN. Pain, if present, was denominated "tingling" and "cold" in the MPQ. Median TNSc score increased from T0 (2.43) to T1 (4.71) to T2 (5.50) to T3 (5.57), as did pinprick and cold sensation disturbances in SGDT. PPT and associated NRS remained unchanged. TNSc and SGDT at T1 could not predict the NCI-CTC grade at T3.

CONCLUSION: NCI-CTC, TNSc, and stocking and glove distribution testing can be used in the early diagnosis and monitoring of CIPN, with false-positive findings at baseline. Final NCI-CTC grades could not be predicted.