The association between vincristine-induced peripheral neuropathy and health-related quality of life in children with cancer

Cancer Med. 2021 Nov;10(22):8172-8181. doi: 10.1002/cam4.4289. Epub 2021 Nov 1.

Abstract

Purpose: Vincristine (VCR) is a chemotherapeutic agent used in the treatment of pediatric oncology patients, but its main toxicity is VCR-induced peripheral neuropathy (VIPN). However, whether VIPN has an effect on health-related quality of life (HR-QoL) in children during treatment is unknown. Therefore, the aim of our study was to investigate the association between VIPN and HR-QoL in children starting treatment for cancer.

Methods: Measurements of VIPN were performed using two tools: Common Terminology Criteria for Adverse Events (CTCAE) and pediatric-modified Total Neuropathy Score (ped-mTNS). Assessment of HR-QoL was done with self- and proxy assessment of the Cancer and Generic module of the Pediatric Cancer Quality of Life Inventory™ (PedsQL).

Results: In total, N = 86 children were included. HR-QoL of children with VIPN (n = 67%, 76%) was significantly lower in comparison with children without VIPN: estimated Total score of PedsQL Generic (proxy) 84.57; β = -8.96 and 95% confidence interval (CI) -14.48 to -3.43; p = 0.002, estimated PedsQL Generic Total score (self-reported): 85.16, β = -8.38 (95% CI: -13.76 to -3.00); p = 0.003. Similar results were found in the Pain and Hurt domain of the PedsQL Cancer (pain: estimated score [proxy]: 85.28, β = -9.94 [95%CI: -16.44 to -3.45], p = 0.003; hurt: estimated score [self-report] 97.57, β = -19.15 [95%CI: -26.82 to -11.48], p < 0.001).

Conclusion: VIPN results in a significant reduction of HR-QoL in children under treatment for a malignancy, which means that VIPN is important for the well-being of pediatric oncology patients. Therefore, this study underlines the importance of optimizing treatment with VCR, thereby aiming to reduce VIPN while maintaining efficacy.

Keywords: PedsQL; cancer; children; neurotoxicity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Female
  • Humans
  • Male
  • Neoplasms / complications*
  • Neoplasms / drug therapy
  • Neoplasms / mortality
  • Peripheral Nervous System Diseases / chemically induced*
  • Prospective Studies
  • Quality of Life
  • Survival Analysis
  • Vincristine / pharmacology
  • Vincristine / therapeutic use*

Substances

  • Vincristine