Time-dependent discrepancies between physician-assessed and patient-reported oxaliplatin-induced peripheral neuropathy i
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ORIGINAL ARTICLE
Time-dependent discrepancies between physician-assessed and patient-reported oxaliplatin-induced peripheral neuropathy in patients with metastatic colorectal cancer who received mFOLFOX6 plus bevacizumab: a post hoc analysis (WJOG4407GSS2) Yuji Miura 1 & Masahiko Ando 2 & Kentaro Yamazaki 3 & Shuichi Hironaka 4 & Narikazu Boku 5 & Kei Muro 6 & Ichinosuke Hyodo 7 Received: 24 July 2020 / Accepted: 11 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Cumulative sensory neurotoxicity induced by oxaliplatin impairs patients’ quality of life and treatment continuation. This study investigated the relationship between physician-assessed and patient-reported oxaliplatin-induced peripheral neuropathy (OIPN) during treatment of metastatic colorectal cancer (mCRC) over time. Methods A post hoc analysis was conducted for 191 patients with mCRC who received mFOLFOX6 plus bevacizumab in the WJOG4407G trial. Physician-assessed OIPN was graded by CTCAE every 2 weeks. Patient-reported OIPN was assessed with the FACT/GOG-Ntx (11 items, best score 44) at baseline and at 3, 6, and 9 months. Physician underestimation was defined as when the highest scores of the NTX1–4 sensory subscale/CTCAE grade were 2/0, 3/0–1, or 4/0–1, and overestimation as 0/2–3, 1/2–3, or 2/3. Results The median total dose (range) of oxaliplatin was 762 (85–5950) mg/m2. Overall, the least squares mean of FACT/GOGNtx scores (standard error), estimated by a linear mixed model, were 36 (0.8), 34 (0.9), 29 (1.0), and 27 (1.1) for CTCAE grades 0, 1, 2, and 3, respectively. FACT/GOG-Ntx scores were weakly-to-moderately correlated with CTCAE grade (Spearman’s r = − 0.24 [p = 0.0026], − 0.46 [p < 0.0001], and − 0.56 [p < 0.0001] at 3, 6, and 9 months, respectively). OIPN was underestimated in 85/159 (54%), 43/109 (39%), and 18/69 (26%) patients at 3, 6, and 9 months, respectively. In contrast, OIPN was overestimated in less than 5% of the patients at any time. Conclusion During early treatment, physician underestimation of OIPN in patients with mCRC is likely. Keywords Oxaliplatin . Peripheral neuropathy . FACT/GOG-Ntx . Patient-reported outcome
Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s00520-02005891-2. * Yuji Miura [email protected] 1
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Department of Medical Oncology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
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Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Oita, Japan
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Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
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Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
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Division of Gastroenterology, University of Tsukuba, Tsukuba, Japan
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Introduction Oxaliplatin is a platinum agent used widely in combination with o
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