The impact of chemotherapy-induced peripheral neuropathy (CIPN) on cancer survivor quality of life is increasingly understood, however there is no standardised assessment approach. Clinicians commonly underestimate the significance and severity. Patient-reported outcomes (PRO) are increasingly utilised, to enhance symptom management and well-being. This study aimed to evaluate CIPN PROs, the correlation with medical/nursing assessments and assess feasibility of a tablet-based system.
Patients receiving platinum or taxane chemotherapy at RNSH were eligible. Patients completed a questionnaire containing standardised CIPN PRO assessments (EORTC CIPN-20, PNQ, NCI PRO-CTCAE) via tablet device. NCI CTCAE grading scale medical (median 7 days from PRO) and nursing (day of PRO) assessments from the medical record were correlated with PRO (Spearman’s correlation and linear regression). A subset completed follow-up questionnaires after further cumulative chemotherapy.
44 patients completed questionnaires, with 12 follow-ups (median further 59.5 days). 61.4% received platinum chemotherapy, 54.5% taxane and 15.9% combination platinum-taxane. 47.7% exceeded a cumulative dose associated with CIPN. 59% reported symptoms of tingling or numbness, with 32% reporting ‘quite a bit’ or ‘very much’ tingling/numbness in hands/feet. Correlation of medical assessment (n=29, 51.8%) with EORTC sensory scale (r2=0.357, p<0.01), PNQ1 sensory scale (r2=0.382, p<0.01) and NCI PRO-CTCAE severity (r2=0.374, p<0.01) and functional impact (r2=0.149, p=0.04) scales was poor. Nursing assessment (n=54, 96.4%) correlation with EORTC sensory scale (r2=0.241, p<0.01), PNQ1 (r2=0.385, p<0.01) and NCI PRO-CTCAE severity (r2=0.476, p<0.01) and functional impact (r2=0.177, p<0.01) scales were similarly poor. Ten follow-up patients had increase in PRO symptoms, however none had documented medical assessment change. Rating for ease of use (scale 1-10) of tablet questionnaire showed high feasibility (mean value 9.63, SD 0.82).
Tablet questionnaire of CIPN PRO demonstrated excellent feasibility. Medical and nursing assessment correlation with PRO was poor. Further evaluation of CIPN PRO impact on clinical treatment decisions is warranted.