Marie Selvy1, Bruno Pereira2, Nicolas Kerckhove3, Jérôme Busserolles4, Fadila Farsi5, Virginie Guastella6, Patrick Merle7, Denis Pezet8, David Balayssac9. 1. CHU Clermont-Ferrand, INSERM U1107 NEURO-DOL, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France. 2. Délégation de la recherche clinique et de l'innovation, Biostatistics Unit, CHU Clermont-Ferrand, F-63000, Clermont-Ferrand, France. 3. CHU Clermont-Ferrand, INSERM U1107 NEURO-DOL, Institut ANALGESIA, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France. 4. INSERM U1107 NEURO-DOL, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France. 5. Réseau Régional de Cancérologie ONCO-AURA, CRLCC Léon Bérard, F-69373, Lyon Cedex 08, France. 6. Service de soins palliatifs, CHU Clermont-Ferrand, F-63000, Clermont-Ferrand, France. 7. Service de Pneumologie, CHU Clermont-Ferrand, F-63000, Clermont-Ferrand, France. 8. INSERM U1071, M2iSH, USC-INRA 2018, CHU Clermont-Ferrand, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France. 9. CHU Clermont-Ferrand, INSERM U1107 NEURO-DOL, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France. dbalayssac@chu-clermontferrand.fr.
Abstract
PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) is challenging for oncologists. Many publications mention the high incidence of CIPN and the lack of effective preventive/management strategies and robust diagnostic tools. This cross-sectional study was aimed at assessing the practice of French oncologists for CIPN prevention, diagnosis and management. METHODS: This web-based survey was sent to French oncologists by the regional cancer networks. Incidence and impact of CIPN were assessed using visual analogue scales (VAS) and diagnostic strategies were recorded. Also recorded were the drugs used to prevent or manage CIPN and their perceived efficacy and safety (VAS). RESULTS: Among the 210 oncologists included, the perceived incidence of CIPN was about 36.2 ± 22.1% of patients. About 99.5% of oncologists declared that they assess CIPN during medical follow-up. The use of drugs to prevent CIPN was reported by 9.6% of oncologists (group B vitamins (35.0%) and calcium and magnesium infusion (25.0%)). In the case of CIPN, the therapeutic adjustment of neurotoxic anticancer drugs is performed by 99.0% of oncologists (chemotherapy change (49.8%), dose reduction (30.9%) or interruption (19.3%)). The pharmacological management of CIPN was declared by 72.9% of oncologists. The main drugs used are pregabalin (75.8%), amitriptyline (32.7%) and gabapentin (25.5%). Duloxetine (ASCO recommendation) is used by only 11.8% of oncologists. CONCLUSION: Oncologists were clearly aware of CIPN risks, but its incidence tended to be underestimated and the ASCO recommendations for the management of CIPN were not followed. The prevention, diagnosis and management of CIPN remain problematic in clinical practice in France. TRIAL REGISTRATION: ClinicalTrials.gov : NCT03854864.
PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) is challenging for oncologists. Many publications mention the high incidence of CIPN and the lack of effective preventive/management strategies and robust diagnostic tools. This cross-sectional study was aimed at assessing the practice of French oncologists for CIPN prevention, diagnosis and management. METHODS: This web-based survey was sent to French oncologists by the regional cancer networks. Incidence and impact of CIPN were assessed using visual analogue scales (VAS) and diagnostic strategies were recorded. Also recorded were the drugs used to prevent or manage CIPN and their perceived efficacy and safety (VAS). RESULTS: Among the 210 oncologists included, the perceived incidence of CIPN was about 36.2 ± 22.1% of patients. About 99.5% of oncologists declared that they assess CIPN during medical follow-up. The use of drugs to prevent CIPN was reported by 9.6% of oncologists (group B vitamins (35.0%) and calcium and magnesium infusion (25.0%)). In the case of CIPN, the therapeutic adjustment of neurotoxic anticancer drugs is performed by 99.0% of oncologists (chemotherapy change (49.8%), dose reduction (30.9%) or interruption (19.3%)). The pharmacological management of CIPN was declared by 72.9% of oncologists. The main drugs used are pregabalin (75.8%), amitriptyline (32.7%) and gabapentin (25.5%). Duloxetine (ASCO recommendation) is used by only 11.8% of oncologists. CONCLUSION: Oncologists were clearly aware of CIPN risks, but its incidence tended to be underestimated and the ASCO recommendations for the management of CIPN were not followed. The prevention, diagnosis and management of CIPN remain problematic in clinical practice in France. TRIAL REGISTRATION: ClinicalTrials.gov : NCT03854864.
Entities:
Keywords:
Adverse drug reaction; Cancer; Chemotherapy-induced peripheral neuropathy; Oncologists; Professional practice
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