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Updated: Jul 19, 2025
Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity
Published on: April 26, 2012
Assessment of proxy-reported responses as predictors of motor and sensory peripheral neuropathy in children with
Rozalyn L Rodwin1,2, Natalie J DelRocco3, Emily Hibbitts3
1Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA.
Insights
Parental reports using the Pediatric Outcomes Data Collection Instrument showed moderate success in identifying motor chemotherapy-induced peripheral neuropathy (CIPN) in children. However, identifying sensory CIPN requires new methods for accurate diagnosis.
Area of Science:
- Pediatric Oncology
- Neurology
- Clinical Trial Analysis
Background:
- Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent and challenging complication in pediatric acute lymphoblastic leukemia (ALL) treatment.
- Accurate diagnosis of CIPN is crucial for managing treatment side effects and long-term patient outcomes.
- Current diagnostic methods may not fully capture the nuances of CIPN in pediatric populations.
Purpose of the Study:
- To evaluate the effectiveness of parent/guardian proxy-reported data from the Pediatric Outcomes Data Collection Instrument (PODCI) in identifying motor and sensory CIPN in children undergoing ALL treatment.
- To assess the diagnostic performance of PODCI in detecting CIPN as diagnosed by physical and occupational therapists (PT/OT).
Main Methods:
- Utilized data from the Children's Oncology Group AALL0932 physical function study.
- Employed logistic regression and calculated c-indices to assess the discriminative ability of PODCI variables for motor and sensory CIPN.
- Compared PODCI-based models against PT/OT diagnoses of CIPN.
Main Results:
- Four PODCI variables demonstrated moderate discrimination for identifying motor CIPN (c-index 0.76).
- Models for sensory CIPN and optimism-corrected models showed weak discrimination (c-index 0.65).
- Existing proxy-report measures are insufficient for reliably identifying PT/OT-diagnosed sensory CIPN.
Conclusions:
- Parental proxy reports via PODCI can partially identify motor CIPN in children with ALL.
- Current PODCI measures are inadequate for detecting sensory CIPN.
- Development of novel proxy-report instruments is necessary to improve the identification of CIPN in pediatric oncology patients.
Abstract:
Chemotherapy-induced peripheral neuropathy (CIPN), a common condition in children with acute lymphoblastic leukemia, can be challenging to diagnose. Using data from Children's Oncology Group AALL0932 physical function study, we sought to determine if parent/guardian proxy-reported responses from the Pediatric Outcomes Data Collection Instrument could identify children with motor or sensory CIPN diagnosed by physical/occupational therapists (PT/OT). Four variables moderately discriminated between children with and without motor CIPN (c-index 0.76, 95% confidence interval [CI]: 0.64-0.84), but sensory and optimism-corrected models had weak discrimination (c-index sensory models 0.65, 95% CI: 0.54-0.74). New proxy-report measures are needed to identify children with PT/OT diagnosed CIPN.
