Identifying trajectories and predictors of chemotherapy-induced peripheral neuropathy symptoms, physical functioning, and falls across treatment and recovery in adults treated with neurotoxic chemotherapy: the PATTERN observational study protocol (NCT05790538).

Autor: Winters-Stone KM; Knight Cancer Institute, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA. wintersk@ohsu.edu., Krasnow SM; Knight Cancer Institute, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA., Horak FB; Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR, USA., Mancini M; Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR, USA., Cameron MH; Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR, USA.; VA Portland Health Care System, Portland, OR, USA., Dieckmann NF; School of Nursing, Oregon Health & Science University, Portland, OR, USA.; Division of Psychology, Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland, OR, USA., Stoyles SA; School of Nursing, Oregon Health & Science University, Portland, OR, USA., Roeland EJ; Knight Cancer Institute, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
Jazyk: angličtina
Zdroj: BMC cancer [BMC Cancer] 2023 Nov 10; Vol. 23 (1), pp. 1087. Date of Electronic Publication: 2023 Nov 10.
DOI: 10.1186/s12885-023-11546-2
Abstrakt: Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and dose-limiting side effect of systemic cancer therapy. In many cancer survivors, CIPN persists after treatment ends and is associated with functional impairments, abnormal gait patterns, falls, and diminished quality of life. However, little is known regarding which patients are most likely to develop CIPN symptoms that impair mobility and increase fall risk, when this risk develops, or the optimal timing of early intervention efforts to mitigate the impact of CIPN on functioning and fall risk. This study will address these knowledge gaps by (1) characterizing trajectories of symptoms, functioning, and falls before, during, and after treatment in adults prescribed neurotoxic chemotherapy for cancer; and (2) determining the simplest set of predictors for identifying individuals at risk for CIPN-related functional decline and falls.
Methods: We will enroll 200 participants into a prospective, observational study before initiating chemotherapy and up to 1 year after completing chemotherapy. Eligible participants are aged 40-85 years, diagnosed with stage I-III cancer, and scheduled to receive neurotoxic chemotherapy. We perform objective assessments of vibratory and touch sensation (biothesiometry, tuning fork, monofilament tests), standing and dynamic balance (quiet stance, Timed-Up-and-Go tests), and upper and lower extremity strength (handgrip dynamometry, 5-time repeated chair stand test) in the clinic at baseline, every 4-6 weeks during chemotherapy, and quarterly for 1 year post-chemotherapy. Participants wear devices that passively and continuously measure daily gait quality and physical activity for 1 week after each objective assessment and self-report symptoms (CIPN, insomnia, fatigue, dizziness, pain, cognition, anxiety, and depressive symptoms) and falls via weekly electronic surveys. We will use structural equation modeling, including growth mixture modeling, to examine patterns in trajectories of changes in symptoms, functioning, and falls associated with neurotoxic chemotherapy and then search for distinct risk profiles for CIPN.
Discussion: Identifying simple, early predictors of functional decline and fall risk in adults with cancer receiving neurotoxic chemotherapy will help identify individuals who would benefit from early and targeted interventions to prevent CIPN-related falls and disability.
Trial Registration: This study was retrospectively registered with ClinicalTrials.gov (NCT05790538) on 3/30/2023.
(© 2023. The Author(s).)
Databáze: MEDLINE
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