Is quantitative sensory testing helpful in the management of oxaliplatin neuropathy? a two-year clinical study

Abstract

Purpose: To better understand how quantitative sensory testing could help the clinician in the management of oxaliplatin-induced peripheral neuropathy in terms of earlier and more reliable detection, we conducted a two-year prospective study.

Methods: Thermal sensory assessment, tactile sensory assessment, neuropathic pain assessment and adverse events gradation (NCI-CTC) were performed during treatment and 6 months after treatment completion.

Results: 35 patients were enrolled and followed-up during one year. Cold and Warm Detection Thresholds were higher 6 months after treatment completion than at enrollment. Mechanical detection thresholds didn't change significantly. Neurotoxicity was mostly grade-1, only 18% grade-2 and no grade-3. Grade-2 patients received lower oxaliplatin cumulative dose than grade-1, which reveals effective dose adaptation and grade-2 patients were more likely to develop painful neuropathy.

Conclusion: Thermal thresholds impairment emerges too late to help the clinician in the prophylaxis of neuropathy. Management of OXA-treatment based on NCI-CTC, as currently recommended, remains the best way to detect neuropathy and ensure treatment adaptation.

Keywords: ADL; Activity of daily living; CDT; Cold Detection Threshold; Common Terminology Criteria For Adverse Events From The National Cancer Institute; Hypoesthesia; MDT; Mechanical Detection Threshold; NCI-CTCAE; NPSI; Neuropathic Pain Symptoms Inventory; OIPN; Oxaliplatin; Oxaliplatin-induced peripheral neuropathy; Peripheral neuropathy; QST; Quantitative sensory testing; Thermal detection threshold; WDT; Warm Detection Threshold.