Article

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], 1.04-2.64) without evidence for a dose
response. Platinum exposure was associated with increased risk of sensory
impairment (adjusted OR=1.62; 95% CI, .97-2.72) without evidence of a dose
response. Sensory impairment was associated with poor endurance (OR=1.99; 95% CI,
.99-4.0) and mobility (OR=1.65; 95% CI, .96-2.83). 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.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS