Neuropathy Among Childhood Cancer Survivors
Lisa Schulmeister, MN, RN, FAAN
Chemotherapy-induced peripheral neuropathy (CIPN) is a potentially long-lasting adverse effect of cancer treatment for survivors of childhood cancer.
Childhood cancer treatment has improved significantly over the past 60 years, and a child who survives 5 or more years after diagnosis now has a life span comparable to that of other children of that age. However, some children experience adverse effects of treatment, and some of these effects have long-term implications.
Chemotherapy-induced peripheral neuropathy (CIPN) is a potentially long-lasting adverse effect of treatment with commonly used agents, such as the vinca alkaloids, cisplatin, and carboplatin. To assess long-term effects of CIPN, researchers compared 121 childhood cancer survivors who were treated with chemotherapy for an extracranial malignancy before age 17 to healthy age-matched controls. The childhood cancer survivors had neurotoxicity assessments at a median age of 16 years, which was a median of 8.5 years after treatment completion.
Results of the study, published in JAMA Neurology, showed that CIPN was observed in 54 of 107 children (50%) who were treated with neurotoxic chemotherapy and met study inclusion criteria. Sensory deficits were more commonly observed in the legs and functional deficits were observed in manual dexterity and balance.
The researchers concluded that CIPN is prevalent among childhood cancer survivors and persists long term. These findings have implications for cancer rehabilitation as well as the development of neuroprotective agents.