Two studies evaluating SUDOSCAN
Severe drug-induced neurotoxic adverse effects constitute the second most common cause of dose limitation after haematological adverse effects. Chemotherapy Induced Polyneuropathy (CIPN) is commonly associated with platinum analogues, antitubulins (taxane), the proteasome inhibitor bortezomib, and thalidomide. However, it is poorly investigated at an early stage due to the lack of
a simple assessment tool.
As sweat glands are innervated by small autonomic C-fibers, sudomotor function testing has been suggested for early screening of peripheral neuropathy.
Two important studies have evaluated SUDOSCAN performances in the detection and follow-up of CIPN.
Quick, non-invasive and quantitative assessment of small fiber neuropathy in patients receiving chemotherapy
Saad M, Psimaras D, Tafani C, Sallansonnet-Froment M, Calvet JH, Vilier A, Tigaud JM, Bompaire F, Lebouteux M, de Greslan T, Ceccaldi B, Poirier JM, Ferrand FR, Le Moulec S, Huillard O, Goldwasser F, Taillia H, Maisonobe T, Ricard D.
J Neurooncol. 2016 Apr;127(2):373-80.
Background: The Total Neuropathy Score clinical version (TNSc) explores large and small fibers neuropathy, with a score that ranges from 0 to 28 with a higher sensitivity than other scales. TNSc is
a seven item composite clinical neuropathy scale that includes symptoms, signs and ability is a validated and reliable CIPN scale. To date this scale seems to be the best compromise between reliability and simplicity but is not completely objective and requires training.
Aim: compare SUDOSCAN and TNSc in the assessment of CIPN.
Methods: 88 patients receiving at least two infusions of Oxaliplatin only (45.4 %), Paclitaxel only (14.8 %), another drug only (28.4 %) or two drugs (11.4 %) were enrolled in the study. At each chemotherapy infusion the accumulated dose of chemotherapy was calculated, TNSc and SUDOSCAN were carried out.
Results: For patients receiving Oxaliplatin mean hands ESC changed from 73 ± 2 to 63 ± 2 and feet ESC from 77 ± 2 to 66 ± 3 µS (p<0.001) while TNSc changed from 2.9 ± 0.5 to 4.3 ± 0.4. Similar results were observed in patients receiving Paclitaxel or another neurotoxic chemotherapy. During the follow-up, ESC values of both hands and feet with a corresponding TNSc < 2 were 70 ± 2 and 73 ± 2µS respectively while they were 59 ± 1.4 and 64 ± 1.5 µS with a corresponding TNSc > 6 (p<0.0001 and p = 0.0003 respectively).