[Latar belakang: Neuropati perifer terinduksi kemoterapi (NPTK) merupakan
efek samping kemoterapi neurotoksik yang menurunkan kualitas hidup penderita
dan menghalangi pemberian kemoterapi yang optimal. Suatu alat skrining dengan
tingkat akurasi mendekati alat elektroneurografi (ENG) dibutuhkan untuk
mendeteksi NPTK secara dini. Skor Toronto clinical scoring system (TCSS)
merupakan alat skrining sederhana dan terbukti unggul untuk pemeriksaan
neuropati pada diabetes melitus (DM). Kesamaan gambaran klinis antara
neuropati DM dengan NPTK dapat menjadikan TCSS sebagai alat skrining untuk
NPTK.
Tujuan: Mencari nilai ROC, senstivitas dan spesifisitas TCSS dibandingkan
dengan standar baku pemeriksaan ENG
Metode penelitian: Penelitian berupa uji diagnostik skor TCSS pada penderita
keganasan yang mendapat kemoterapi cisplatin di poli hematoonkologi dan ruang
perawatan kemoterapi RS Ciptomangunkusumo. Pemeriksaan ENG dan skor
TCSS dilakukan pada setiap subjek. Hasil dianalisa untuk mendapatkan kurva
ROC, sensitivitas dan spesifisitas.
Hasil: Dari 77 subjek, terdapat 66 yang dapat dianalisa. Diagnosis polineuropati
dengan menggunakan ENG sebanyak 34 (51,5%), begitu juga dengan
menggunakan TCSS (51,5%). Komponen abnormal TCSS terbanyak adalah
komponen pemeriksaan refleks tendon (78,8%). Dari analisa uji diagnostik
didapatkan nilai AUC 75,4%, sensitivitas 79,4%, spesifisitas 59,4%, nilai prediksi
positif 67,5% dan nilai prediksi negatif 73,1%, dengan titik potong optimal ≥ 5.
Kesimpulan: Skor TCSS memiliki nilai diagnostik yang cukup baik sebagai alat
skrining pada NPTK. Skor ini juga memiliki nilai titik potong optimal yang sesuai
dengan karakteristik klinis NPTK dan komponen yang dapat digunakan untuk
mendeteksi gejala awal NPTK.;Background: Chemotherapy induced peripheral neuropathy (CIPN) is an
adverse effect of neurotoxic chemotherapy that lower the patient’s quality of life
and prevent optimal chemotherapy. Early detection by a screening tool that have a
near accuracy to electroneurography (ENG) is needed. The Toronto clinical
scoring system (TCSS) is a simple and superior tool for screening diabetic
neuropathy. Similarity between diabetic neuropathy and CIPN’s clinical picture
could make the TCSS as screening tool for CIPN.
Purpose: to discover the ROC, sensitivity and specificity of TCSS compared to
the ENG as gold standard
Methodology: the study is a diagnostic test of TCSS in cancer patients with
cisplatin from Hematooncology clinic and chemotherapy ward of RSCM. ENG
test and TCSS examination were done for each subject. Results were analyzed for
ROC, sensitivity and specificity.
Result: out of 77 subjects, only 66 were analyzed. CIPN were diagnosed in 34
(51,5%) by ENG, and also in 34 (51,5%) by TCSS. The most abnormal
component of TCSS is the tendon reflex examination (78,8%). The diagnostic
analysis acquire the AUC 75,4%, 79,4% sensitivity, 59,4% specificity, positive
predictive value of 67,5% and negative predictive value of 73,1%. The optimal
cut off point is ≥ 5.
Conclusion: The TCSS is a passable screening tool for CIPN. It also have optimal
cut-off point which resemble CIPN’s clinical characteristics and component
which can be use to detect early signs., Background: Chemotherapy induced peripheral neuropathy (CIPN) is an
adverse effect of neurotoxic chemotherapy that lower the patient’s quality of life
and prevent optimal chemotherapy. Early detection by a screening tool that have a
near accuracy to electroneurography (ENG) is needed. The Toronto clinical
scoring system (TCSS) is a simple and superior tool for screening diabetic
neuropathy. Similarity between diabetic neuropathy and CIPN’s clinical picture
could make the TCSS as screening tool for CIPN.
Purpose: to discover the ROC, sensitivity and specificity of TCSS compared to
the ENG as gold standard
Methodology: the study is a diagnostic test of TCSS in cancer patients with
cisplatin from Hematooncology clinic and chemotherapy ward of RSCM. ENG
test and TCSS examination were done for each subject. Results were analyzed for
ROC, sensitivity and specificity.
Result: out of 77 subjects, only 66 were analyzed. CIPN were diagnosed in 34
(51,5%) by ENG, and also in 34 (51,5%) by TCSS. The most abnormal
component of TCSS is the tendon reflex examination (78,8%). The diagnostic
analysis acquire the AUC 75,4%, 79,4% sensitivity, 59,4% specificity, positive
predictive value of 67,5% and negative predictive value of 73,1%. The optimal
cut off point is ≥ 5.
Conclusion: The TCSS is a passable screening tool for CIPN. It also have optimal
cut-off point which resemble CIPN’s clinical characteristics and component
which can be use to detect early signs.]