Peripheral motor and sensory neuropathy in survivors of childhood central nervous system (CNS) tumors in the St. Jude Lifetime (SJLIFE) cohort.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 10549-10549
Author(s):  
Rozalyn L Rodwin ◽  
Lu Lu ◽  
Deo Kumar Srivastava ◽  
Tara M. Brinkman ◽  
Kevin R. Krull ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peripheral Neuropathy ◽  
Sensory Neuropathy ◽  
Tumor Location ◽  
Cns Tumors ◽  
Motor Neuropathy ◽  
Independent Risk Factors ◽  
Community Controls ◽  
Peripheral Motor ◽  
Motor And Sensory Neuropathy

10549 Background: Survivors of CNS tumors are at risk for peripheral motor and sensory neuropathy. Chemotherapy’s contribution to peripheral neuropathy has not been well studied in this population. We aimed to estimate the prevalence of peripheral neuropathy, and determine its association with tumor characteristics and treatment exposures. Methods: Within the SJLIFE cohort, survivors of CNS tumors (n = 363, median [range] age 24 [18-53] years, 43.3% female) ≥10 years from diagnosis and ≥ 18 years at evaluation completed in-person assessments for peripheral motor and sensory neuropathy (defined as abnormal motor or sensory subscales of the Modified Total Neuropathy Score). For comparison, matched community controls (n = 445, median [range] age 34 [18-70] years, 55.7% female) underwent the same assessment. Prevalence of ≥ grade 2 motor or sensory neuropathy was estimated by a modified Common Terminology Criteria for Adverse Events. Multivariable analyses adjusting for age, sex and race were used to identify associated disease and treatment characteristics. Results: Overall, 11.0% of survivors of CNS tumors versus 0.9% of controls had ≥grade 2 motor neuropathy (p < 0.001), and 15.7% of survivors of CNS tumors versus 2.3% of controls had ≥grade 2 sensory neuropathy (p < 0.001). Prevalence of motor and sensory neuropathy varied by diagnosis (Table). Vinca alkaloid exposure (OR 3.5, 95% CI 1.7-7.0) and infratentorial tumor location (OR 2.5, 95% CI 1.1-5.4, reference supratentorial location) were independent risk factors for sensory neuropathy. Infratentorial tumor location was also associated with an increased risk of motor neuropathy (OR 2.4, 95% CI 1.2-4.8). History of radiation and surgery were not significant independent risk factors for motor or sensory neuropathy. Conclusions: Prevalence of peripheral motor and sensory neuropathy was significantly higher in survivors of CNS tumors than in matched community controls. Survivors of CNS tumors would benefit from increased surveillance to identify and treat peripheral neuropathy, especially in those who received vinca alkaloids or had infratentorial tumors. [Table: see text]

scholarly journals Lack of Anatomical Concordance between Preablation and Postablation CT Images: A Risk Factor Related to Ablation Site Recurrence

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Petra G. Kele ◽  
Eric J. Van der Jagt ◽  
Paul F. M. Krabbe ◽  
Koert P. de Jong
Keyword(s):  
Risk Factors ◽  
Tumor Size ◽  
Tumour Size ◽  
Tumor Location ◽  
Ct Images ◽  
Cox Proportional Hazard ◽  
Independent Risk Factors ◽  
Index Tumor ◽  
Index Tumour

Objective. Variation in the position of the liver between preablation and postablation CT images hampers assessment of treatment of colorectal liver metastasis (CRLM). The aim of this study was to test the hypothesis that discordant preablation and postablation imaging is associated with more ablation site recurrences (ASRs).Methods. Patients with CRLM were included. Index-tumor size, location, number, RFA approachs and ablative margins were obtained on CT scans. Preablation and postablation CT images were assigned a “Similarity of Positioning Score” (SiPS). A suitable cutoff was determined. Images were classified as identical (SiPS-id) or nonidentical (SiPS-diff). ASR was identified prospectively on follow-up imaging.Results. Forty-seven patients with 97 tumors underwent 64 RFA procedures (39 patients/63 tumors open RFA, 25 patients/34 tumours CT-targeted RFA, 12 patients underwent >1 RFA). Images of 52 (54%) ablation sites were classified as SiPS-id, 45 (46%) as SiPS-diff. Index-tumor size, tumor location and number, concomitant partial hepatectomy, and RFA approach did not influence the SiPS. ASR developed in 11/47 (23%) patients and 20/97 (21%) tumours. ASR occurred less frequently after open RFA than after CT targeted RFA (P<0.001). ASR was associated with larger index-tumour size (18.9 versus 12.8 mm,P=0.011). Cox proportional hazard model confirmed SiPS-diff, index-tumour size >20 mm and CT-targeted RFA as independent risk factors for ASR.Conclusion. Variation in anatomical concordance between preablation and postablation images, index-tumor size, and a CT-targeted approach are risk factors for ASR in CRLM.

scholarly journals Is Neuropathic Pain a Good Marker of Peripheral Neuropathy in Hospice Patients with Advanced Cancer? The Single Center Pilot Study

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1377
Author(s):  
Joanna Drat-Gzubicka ◽  
Anna Pyszora ◽  
Jacek Budzyński ◽  
David Currow ◽  
Małgorzata Krajnik
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Advanced Cancer ◽  
Clinical Signs ◽  
Sensory Neuropathy ◽  
Motor Neuropathy ◽  
Karnofsky Score ◽  
Burning Pain ◽  
Hospice Patients ◽  
Rule Out

Neuropathic pain (NP) affects approximately 30% of patients with advanced cancer. The prevalence of neuropathic pain related to peripheral neuropathy (NP-RPN) in these patients is not known. The aim of the study was to evaluate NP-RPN prevalence in hospice patients and to find out whether the absence of this pain is sufficient to rule out peripheral neuropathy. The study included a total of 76 patients with advanced cancer who were cared for at inpatient hospices. All patients were asked about shooting or burning pain (of the feet and hands), were examined systematically for sensory deficits and had a nerve conduction study performed. NP-RPN was found in 29% of the patients. Electrophysiologically-diagnosed peripheral neuropathy was found in 79% of patients, and the diagnostic electrophysiological criteria for neuropathy were met by one half of the patients without NP-RPN. The severity of NP-RPN was correlated with the clinically assessed severity of sensory neuropathy and the Karnofsky score, but was not correlated with the intensity of the clinical signs of motor neuropathy. The presence of NP-RPN did not reflect greater prevalence of motor and sensory abnormalities in neurological and electrophysiological examinations. The absence of NP-RPN did not rule out polyneuropathy in hospice patients.

scholarly journals Acupuncture and Reflexology for Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer

2017 ◽  
Vol 16 (3) ◽  
pp. 258-262 ◽  
Author(s):  
Idan Ben-Horin ◽  
Peretz Kahan ◽  
Larisa Ryvo ◽  
Moshe Inbar ◽  
Shahar Lev-Ari ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Peripheral Neuropathy ◽  
Cancer Patients ◽  
Medical Records ◽  
Preventive Intervention ◽  
Sensory Neuropathy ◽  
Control Group ◽  
Motor Neuropathy ◽  
Breast Cancer Patients ◽  
Treatment Results

Background: Treatment of chemotherapy-induced peripheral neuropathy (CIPN), which affects approximately 30% to 40% of patients treated with neuropathy-causing agents, is mainly symptomatic. Currently available interventions are of little benefit. Study Design: This study was conducted as a retrospective analysis of the efficacy of acupuncture and reflexology in alleviating CIPN in breast cancer patients. Methods: Medical records of 30 consecutive breast cancer patients who received both chemotherapy and treatment for CIPN according to our Acupuncture and Reflexology Treatment for Neuropathy (ART-N) protocol between 2011 and 2012 were reviewed. Symptom severity was rated at baseline, during, and after treatment. Results: The records of 30 breast cancer patients who had been concomitantly treated with chemotherapy and ART-N for CIPN were retrieved. Two records were incomplete, leaving a total of 28 patients who were enrolled into the study. Twenty patients (71%) had sensory neuropathy, 7 (25%) had motor neuropathy, and 1 (4%) had both sensory and motor neuropathy. Only 2 (10%) of the 20 patients with grades 1 to 2 neuropathy still reported symptoms at 12 months since starting the ART-N protocol. All 8 patients who presented with grades 3 to 4 neuropathy were symptom-free at the 12-month evaluation. Overall, 26 patients (93%) had complete resolution of CIPN symptoms. Conclusion: The results of this study demonstrated that a joint protocol of acupuncture and reflexology has a potential to improve symptoms of CIPN in breast cancer patients. The protocol should be validated on a larger cohort with a control group. It also warrants testing as a preventive intervention.

scholarly journals Cryotherapy for Prevention of Taxane-Induced Peripheral Neuropathy: A Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Junting Jia ◽  
Yimeng Guo ◽  
Raghav Sundar ◽  
Aishwarya Bandla ◽  
Zhiying Hao
Keyword(s):  
Peripheral Neuropathy ◽  
Dose Reduction ◽  
Large Scale ◽  
Meta Analysis ◽  
Gynecological Cancer ◽  
Sensory Neuropathy ◽  
Motor Neuropathy ◽  
Motor Nerves ◽  
Chemotherapy Dose

PurposeTaxanes are widely used in gynecological cancer therapy, however, taxane-induced peripheral neuropathy (TIPN) limits chemotherapy dose and reduces patients’ quality of life. As a safe and convenient intervention, cryotherapy has been recommended as a promising intervention in the recent clinical guidelines for the prevention of TIPN. Although there are a considerable number of studies which explored the use of cryotherapy in preventing chemotherapy-induced peripheral neuropathy (CIPN), there is insufficient large-scale clinical evidence. We performed a meta-analysis on the current available evidence to examine whether cryotherapy can prevent TIPN in cancer patients receiving taxanes.MethodsWe searched databases including PubMed, Embase, and Cochrane from inception to August 3, 2021 for eligible trials. Clinical trials that examined the efficacy of cryotherapy for prevention of TIPN were included. The primary outcome was the incidence of TIPN, and secondary outcomes were incidence of taxane dose reduction and changes in nerve conduction studies. The meta-analysis software (RevMan 5.3) was used to analyze the data.ResultsWe analyzed 2250 patients from 9 trials. Assessments using the Common Terminology Criteria for Adverse Events (CTCAE) score showed that cryotherapy could significantly reduce the incidence of motor and sensory neuropathy of grade≥2 (sensory: RR 0.65, 95%CI 0.56 to 0.75, p&lt;0.00001; motor: RR 0.18, 95% CI [0.03, 0.94], p=0.04). When evaluated using the Patient Neuropathy Questionnaire (PNQ), cryotherapy demonstrated significant reduction in the incidence of sensory neuropathy (RR 0.11, 95% CI 0.04 to 0.31], p&lt;0.0001), but did not show significant reduction in the incidence of motor neuropathy (RR 0.46, 95% CI 0.11 to 1.88, p=0.28). Cryotherapy was associated with reduced incidences of taxane dose reduction due to TIPN (RR 0.48, 95% CI [0.24, 0.95], p=0.04) and had potential to preserve motor nerves.ConclusionsCryotherapy is likely to prevent TIPN in patients receiving taxanes. High quality and sufficient amount of evidence is warranted.

scholarly journals Characteristics of taste alterations in people receiving taxane-based chemotherapy and their association with appetite, weight, and quality of life

2021 ◽  
Author(s):  
Mikiko Kaizu ◽  
Hiroko Komatsu ◽  
Hideko Yamauchi ◽  
Teruo Yamauchi ◽  
Masahiko Sumitani ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Peripheral Neuropathy ◽  
Adverse Events ◽  
Cross Sectional Study ◽  
Dry Mouth ◽  
Cross Sectional ◽  
Independent Risk Factors ◽  
Taste Alteration

Abstract Purpose There is limited evidence on the effect of chemotherapy-associated taste alteration. This study aimed to evaluate taste alteration characteristics in patients receiving taxane-based chemotherapy and investigate the association of taste alterations with appetite, weight, quality of life (QOL), and adverse events. Methods This cross-sectional study evaluated 100 patients receiving paclitaxel, docetaxel, or nab-paclitaxel as monotherapy or combination therapy. Taste alterations were evaluated using taste recognition thresholds and severity and symptom scales. Taste recognition thresholds, symptoms, appetite, weight, and adverse events were compared between patients with and without taste alterations, and logistic regression analysis was performed to identify risk factors. Results Of the 100 patients, 59% reported taste alterations. We found significantly elevated taste recognition thresholds (hypogeusia) for sweet, sour, and bitter tastes in the taste alteration group receiving nab-paclitaxel (p = 0.022, 0.020, and 0.039, respectively). The taste alteration group reported general taste alterations, decline in basic taste, and decreased appetite. Neither weight nor QOL was associated with taste alterations. Docetaxel therapy, previous chemotherapy, dry mouth, and peripheral neuropathy were significantly associated with taste alterations. Conclusions Almost 60% of patients receiving taxane-based regimens, especially docetaxel, reported taste alterations. Taste alteration affected the patient’s appetite but did not affect the weight or QOL. Docetaxel therapy, previous chemotherapy, dry mouth, and peripheral neuropathy were independent risk factors for taste alterations.

scholarly journals Role of the 2018 American Thyroid Association statement on postoperative hypoparathyroidism: a 5-year retrospective study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuxuan Qiu ◽  
Zhichao Xing ◽  
Yuan Fei ◽  
Yuanfan Qian ◽  
Yan Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Parathyroid Hormone ◽  
Independent Risk Factor ◽  
Tumor Location ◽  
Central Neck Dissection ◽  
American Thyroid Association ◽  
Postoperative Hypoparathyroidism ◽  
Independent Risk Factors

Abstract Background Definitions of postoperative hypoparathyroidism (hypoPT) have never reached consent until the American Thyroid Association (ATA) statement was released, with new characteristics and challenges. Methods Patients with papillary thyroid carcinoma who underwent primary total thyroidectomy between January 2013 and June 2018 were retrospectively enrolled. Symptoms of hypocalcemia and their frequency were stringently followed. Patients were divided into groups according to the ATA statement. Incidence of postoperative hypoPT and serum parathyroid hormone levels accompanied by calcium levels, from 1-day to at least 24-month follow-up. Results A total of 1749 patients were included: 458 (26.2%) had transient and 63 (3.6%) had permanent hypoPT. Transient hypoPT was found in 363 (20.7%) patients with biochemical hypoPT, 72 (4.1%) with clinical hypoPT, and 23 (1.3%) with relative hypoPT; permanent hypoPT was detected in 8 (0.5%) patients with biochemical hypoPT, 55 (3.1%) with clinical hypoPT, and none with relative hypoPT. Female sex, age ≥ 55 years, unintentional parathyroid gland resection, and autotransplantation of ≥ 2 parathyroid glands were independent risk factors for transient biochemical hypoPT. Age ≥ 55 years, bilateral central neck dissection, and isthmus tumor location were independent risk factors for transient clinical hypoPT. A postoperative 1-day percentage of parathyroid hormone (PTH) reduction of > 51.1% was an independent risk factor for relative hypoPT (odds ratio, 4.892; 95% confidence interval, 1.653–14.480; P = 0.004). No independent risk factor for permanent hypoPT was found. Conclusion ATA diagnostic criteria for postoperative hypoPT are of great value in differentiating patients by hypocalcemia symptoms and choosing corresponding clinical assistance; however, they may underestimate the actual incidence.

scholarly journals The Andermann Syndrome: Agenesis of the Corpus Callosum Associated with Mental Retardation and Progressive Sensorimotor Neuronopathy

1984 ◽  
Vol 11 (2) ◽  
pp. 257-261 ◽  
Author(s):  
Albert Larbrisseau ◽  
Michel Vanasse ◽  
Pierre Brochu ◽  
Gaétan Jasmin
Keyword(s):  
Mental Retardation ◽  
Corpus Callosum ◽  
Motor Nerve ◽  
Sensory Nerve ◽  
Mental Deficiency ◽  
Sensory Neuropathy ◽  
Motor Deficit ◽  
Motor Neuropathy ◽  
Sensory Nerve Action ◽  
Peripheral Motor

ABSTRACT:Andermann et al. described in 1972 an autosomal recessive inherited syndrome which associates agenesis of the corpus callosum, mental deficiency, and a peripheral motor deficit. We had the opportunity to study in detail 15 patients affected by this syndrome. As in the cases previously reported, the families of these children all originated from Charlevoix County and the Saguenay-Lac St-Jean area in the Province of Quebec.Clinically, these patients have a characteristic facies and moderate mental retardation associated with a progressive motor neuropathy leading to loss of ambulation by adolescence and progressive scoliosis. In 13 of these 15 patients, neuroradiological investigation has shown either total or partial agenesis of the corpus callosum. In every patient in whom these tests were done, sensory nerve action potentials were absent and motor nerve conduction velocities reduced. We also found neurogenic abnormalities both on EMG and neuromuscular biopsies. These abnormalities are similar to those described in Friedreich’s ataxia and in hereditary motor and sensory neuropathy type II, although in our patients the motor deficit is much more severe than in these diseases.The pathogenesis of the peripheral nervous system involvement is still unknown since there have so far been no autopsy studies of this syndrome.

Bortezomib Plus Thalidomide Treatment of Newly Diagnosed Patients with Multiple Myeloma - Efficacy and Neurotoxicity: Results of a Multicenter Study.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3600-3600 ◽  
Author(s):  
Shilun Chen ◽  
Bin Jiang ◽  
Lugui Qiu ◽  
Li Yu ◽  
Yuping Zhong ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Peripheral Neuropathy ◽  
Tumor Lysis Syndrome ◽  
Sensory Neuropathy ◽  
Staging System ◽  
Motor Neuropathy ◽  
Newly Diagnosed ◽  
Best Response ◽  
Grade 3

Abstract Introduction: The standard first-line treatment for patients with multiple myeloma (MM) has been melphalan plus prednisone (MP). However, complete responses (CRs) are rare. As single agents, bortezomib (V) and thalidomide (T) achieved responses in &lt;50% of newly diagnosed MM patients, whereas combinations of V or T with dexamethasone (D), designated VD and TD, demonstrated response rates of 85% and 63%, respectively. We examined the anti-MM activity and neurotoxicity of VT, a steroid-free regimen. Methods: In this phase II study in 30 untreated MM patients, bortezomib 1.3mg/m2 was administered intravenously on days 1, 4, 8, and 11 of a 21-day cycle for up to 8 cycles. Thalidomide 100mg was administered orally at bedtime on days 1 through 21 for up to 8 cycles. Response was assessed with European Group for Blood and Marrow Transplantation (EBMT) criteria. Newly diagnosed MM patients (including Phase IB, II and III according to the International Myeloma Working Group [IMWG] criteria) were eligible if they were 18–80 years of age, had anticipated life expectancy &gt;6 months, and had an age-adjusted creatinine clearance of ≥15 mL/min within 14 days before enrollment. Results: Median age was 56.6 years (range, 30–77), albumin was &lt;3.5g/dL in 18 patients (60%), b2-microglobulin was ≥3.5mg/L in 20 patients (66%), and hemoglobin was ≥100g/L only in 9 patients (30%). International Staging System I/II/III were 3%/50%/47% respectively; all patients had stage III MM according to the IMWG criteria. There were 26 patients (87%) who completed at least two cycles of therapy and were evaluable for response; 18 (60%) completed the planned 8 cycles. Treatment was discontinued in 4 patients due to renal failure. Rates of overall response (ORR), CR, near CR (nCR), partial response (PR), and stable disease (SD) are summarized in Table 1. Median time to response was 35.6 days (range, 7–60). The best response occurred within the first 4 cycles in 96% of patients. Side effects were predictable and manageable. The main toxicities were hematologic (53%), fever (47%), gastrointestinal (40%), fatigue (37%), and peripheral neuropathy (36%). Grade 3 nonhematologic adverse events included 4 patients (15%) with renal failure associated with tumor lysis syndrome, 1 patient (4%) with peripheral sensory neuropathy and motor neuropathy that improved with VT dose reductions, and 1 patient (4%) with hypotension. One patient (4%) experienced Grade 4 thrombocytopenia. One patient (4%) died due to acute renal failure. No deep vein thromboses occurred in this study, compared with a reported incidence of thromboembolic events between 15–20% with TD-containing regimens. Conclusions: VT produced very high ORR and CR in the treatment of newly diagnosed MM patients. No DVTs occurred with this steroid-free combination without any use of anticoagulant drugs. The rate of peripheral neuropathy was lower than expected. This is a very effective regimen with manageable toxicity. Table 1. Response of Newly Diagnosed MM to Bortezomib 1.3mg/m2 and Thalidomide 100mg completed cycles N ORR n (%) CR n (%) nCR n (%) PR n (%) SD n (%) 2 cycles 26 25 (96) 12 (46) 4 (15) 9 (35) 1 (4) 4 cycles 21 20 (95) 6 (29) 7 (33) 7 (33) 0 (0) 8 cycles 18 16 (89) 5 (28) 4 (22) 7 (39) 2 (11)

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