title: The pediatric-modified total neuropathy score: a reliable and valid measure of chemotherapy-induced peripheral neuropathy in children with non-CNS cancers.
abstract: BACKGROUND
  Neurotoxicity is a common side-effect of cancer treatment, but no scales have been validated for the pediatric population. The objective of this study was to test the reliability and validity of the pediatric modified-Total Neuropathy Scale (ped-mTNS) to measure chemotherapy-induced peripheral neuropathy in school-aged children.
  
  
  METHODS
  Forty-one subjects aged 5-18 years undergoing chemotherapy with vincristine or cisplatin and 41 age- and gender-matched controls completed study measures. Subjects were tested with the ped-mTNS at a specified time during treatment. Standardized measures of balance and hand function were completed concurrently. Internal consistency of the ped-mTNS was evaluated using Chronbach's alpha. Validity was tested by comparing case and control ped-mTNS scores as well as testing the hypothesis that ped-mTNS scores would be associated with scores on tests of balance and manual dexterity. Inter-rater and test-retest reliability were each assessed in a subset of 10 subjects.
  
  
  RESULTS
  Twenty-three subjects with acute lymphoblastic leukemia, six with lymphoma, and 12 with solid tumors completed measures along with 41 age- and gender-matched controls. Internal consistency was acceptable with a Chronbach's alpha of 0.76. Children undergoing treatment for cancer had significantly worse scores on the ped-mTNS compared to controls (subjects, 8.7 ± 4.2; controls, 1.4 ± 0.9; p < 0.001). As hypothesized, scores on the ped-mTNS were associated with measures of balance and manual dexterity. Inter-rater and test-retest reliability was acceptable (intraclass correlation coefficients >0.9 each).
  
  
  CONCLUSIONS
  The ped-mTNS is a reliable and valid measure of chemotherapy-induced peripheral neuropathy in school-aged children that is associated with relevant functional limitations.
authors.affiliation: Hematology and Oncology Program, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA. lsgilchrist@stkate.edu
authors.forename: Laura S
authors.initials: LS
authors.lastname: Gilchrist
authors.forename: Lynn
authors.initials: L
authors.lastname: Tanner
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D020258:Neurotoxicity Syndromes / Q000175:diagnosis* / Q000209:etiology; D015588:Observer Variation; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000175:diagnosis*; D015203:Reproducibility of Results
chemical_list: D000970:Antineoplastic Agents