<p> The purpose of this prospective, observational study was to determine if a technique used to detect early signs of small-fiber neuropathy (local skin heating) could detect signs of small-fiber taxane-induced peripheral neuropathy (TIPN) in breast cancer survivors (BCS) during the first 6 weeks of Taxol<sup>®</sup>. Aims of the study were to compare the mean size of (1) axon reflexes and (2) axon flares (both markers of small-fiber nerve function) in BCS receiving Taxol<sup>®</sup> to the size of reflexes/flares in healthy female controls (HCs). A third aim was to determine whether the size of axon reflexes/flares correlated with (a) overall TIPN severity and (b) severity of individual signs/symptoms of TIPN during early Taxol<sup> ®</sup>. </p><p> Data for the study was collected from nine BCS and 20 HCs (<i>N </i> = 29). All BCS had first-time, non-metastatic cancer and received weekly or bi-weekly Taxol<sup>®</sup>. Data was collected at 3 time-points: Time 1 (day 0, before Taxol<sup>®</sup>), Time 2 (day 14), and Time 3 (day 42). Axon reflexes and flares were generated using a validated 40-minute skin heating protocol. Axon reflexes were measured using laser Doppler Flowmetry. Axon flares were measured using full-field laser perfusion imaging. TIPN was measured using the 5-item Short Form of the Total Neuropathy Score (Reduced Version). </p><p> Results identified potential signs of small-fiber TIPN in BCS after 6 weeks of Taxol<sup>®</sup>. Contrary to expectation, axon reflexes were larger for BCS at Time 3 than HCs, suggesting that Taxol<sup>® </sup> may be associated with an increase in small-fiber nerve function like that seen in pre-clinical studies. Clinical signs/symptoms of TIPN were not significantly correlated with axon reflexes or axon flares at the same time point. Analyses of axon flare size were confounded by issues with the data. </p><p> These results add to the growing body of evidence showing that Taxol<sup> ®</sup> affects small-diameter sensory nerves and provides the first evidence in humans that changes in small-fiber nerve function may be detectable after just 6 weeks of Taxol<sup>®</sup> therapy. Studies in larger samples are needed to validate these findings.</p><p>
| Identifer | oai:union.ndltd.org:PROQUEST/oai:pqdtoai.proquest.com:10839712 |
| Date | 30 August 2018 |
| Creators | Zanville, Noah Robert |
| Publisher | Indiana University - Purdue University Indianapolis |
| Source Sets | ProQuest.com |
| Language | English |
| Detected Language | English |
| Type | thesis |
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