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Titre : | Chemotherapy-Related Neuropathic Symptoms and Functional Impairment in Adult Survivors of Extracranial Solid Tumors of Childhood: Results From the St. Jude Lifetime Cohort Study (2013) |
Auteurs : | Kirsten Ness ; Kendra Jones ; Webb Smith ; et al. |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2013/8, 2013) |
Article en page(s) : | pp. 1451-1457 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Rééducation et réadaptation ; Tumeurs |
Mots-clés: | Cisplatin ; Cisplatine ; Neoplasms ; Peripheral nervous system diseases ; Neuropathies périphériques ; Vincristine |
Résumé : |
Objectives To ascertain prevalence of peripheral sensory and motor neuropathy, and to evaluate impairments in relation to function. Design St. Jude Lifetime Cohort Study, a clinical follow-up study designed to evaluate adverse late effects in adult survivors of childhood cancer. Setting A children's research hospital. Participants Eligibility required treatment for an extracranial solid malignancy between 1962 and 2002, age ≥18 years, ≥10 years postdiagnosis, and no history of cranial radiation. Survivors (N=531) were included in the evaluation with a median age of 32 years and a median time from diagnosis of 25 years. Interventions Not applicable. Main Outcome Measures Primary exposure measures were cumulative doses of vinca-alkaloid and platinum-based chemotherapies. Survivors with scores ≥1 on the sensory subscale of the Modified Total Neuropathy Score were classified with prevalent sensory impairment. Those with sex-specific z scores of ≤−1.3 for dorsiflexion strength were classified with prevalent motor impairment. Participants completed the 6-minute walk test (endurance), the Timed Up & Go test (mobility), and the Sensory Organization Test (balance). Results The prevalence of sensory and motor impairment was 20% and 17.5%, respectively. Vinca-alkaloid exposure was associated with an increased risk of motor impairment (adjusted odds ratio [OR]=1.66; 95% confidence interval [CI], 1.042.64) without evidence for a dose response. Platinum exposure was associated with increased risk of sensory impairment (adjusted OR=1.62; 95% CI, .972.72) without evidence of a dose response. Sensory impairment was associated with poor endurance (OR=1.99; 95% CI, .994.0) and mobility (OR=1.65; 95% CI, .962.83). Conclusions Vincristine and cisplatin exposure may increase risk for long-term motor and sensory impairment, respectively. Survivors with sensory impairment are at increased risk for functional performance limitations. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/archives-of-physical-medicine-and-rehabilitation |