title: Prechemotherapy Touch Sensation Deficits Predict Oxaliplatin-Induced Neuropathy in Patients with Colorectal Cancer.
abstract: OBJECTIVE
  We examined the emergence of chemotherapy-induced peripheral neuropathy (CIPN), a dose-limiting toxicity of oxaliplatin, over the course of oxaliplatin-based chemotherapy for colorectal cancer (CRC). Predicting which patients will likely develop CIPN is an ongoing clinical challenge.
  
  
  METHODS
  Oxaliplatin-naïve patients with CRC underwent quantitative sensory testing (QST) before beginning oxaliplatin-based chemotherapy and then rated CIPN-related symptoms via the MD Anderson Symptom Inventory (MDASI) weekly for 26 weeks. Mixed modeling examined the value of QST for predicting higher CIPN (MDASI numbness/tingling) during treatment. Trajectory analysis identified a patient subgroup with consistently higher CIPN symptoms.
  
  
  RESULTS
  Numbness/tingling was the most frequent, most severe symptom, with 51% of patients clustering into a high CIPN subgroup. Touch sensation deficits (Bumps Detection test) significantly predicted the development of more severe numbness/tingling [estimate (est) = 0.106, p = 0.0003]. The high CIPN subgroup reported increased pain (est = 0.472, p < 0.0001) and interference with walking (est = 0.840, p < 0.0001). In the high CIPN subgroup, patient-reported numbness/tingling worsened rapidly in weeks 0-5 (est = 0.57, p < 0.0001) and then more gradually in weeks 6-26 (est = 0.07, p < 0.0001).
  
  
  CONCLUSIONS
  Prechemotherapy screening with a simple, easily administered objective measure of touch sensation deficits (Bumps Detection test) and monitoring of patient-reported numbness/tingling during the first 2-3 chemotherapy cycles may support improved personalized care of CRC patients with oxaliplatin-induced CIPN.
authors.affiliation: Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Tex., USA.
authors.forename: Xin Shelley
authors.initials: XS
authors.lastname: Wang
authors.forename: Qiuling
authors.initials: Q
authors.lastname: Shi
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Dougherty
authors.forename: Cathy
authors.initials: C
authors.lastname: Eng
authors.forename: Tito R
authors.initials: TR
authors.lastname: Mendoza
authors.forename: Loretta A
authors.initials: LA
authors.lastname: Williams
authors.forename: David R
authors.initials: DR
authors.lastname: Fogelman
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D000077150:Oxaliplatin; D010292:Paresthesia / Q000139:chemically induced* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014110:Touch
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin