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Objective <p>Treatment-induced peripheral neuropathy (TIPN) significantly impairs patients’ quality of life, compromises the treatment process, and adversely affects prognosis. The aim of this study was to evaluate the psychometric properties of the Treatment-induced Neuropathy Assessment Scale (TNAS) and establish cutpoints in Chinese patients with cancer.</p> Methods <p>In a prospective cohort of 254 colorectal cancer patients receiving oxaliplatin, the TNAS was assessed for reliability and validity. Using patient-reported walking impairment and CTCAE grades as anchors, optimal cutpoints (CPs) for the numbness, sensory subscale, and interference subscale were derived. Group-Based Trajectory Modeling (GBTM) was subsequently used to examine the clinical utility of the cutpoints.</p> Results <p>The TNAS showed internal consistency (α = 0.92) and repeatability (ICC = 0.85) in Chinese patients. The scale significantly discriminated between patients with and without CTCAE-defined events (1.87 ± 1.60 vs. 1.15 ± 1.72, effect size = 0.44; <i>P</i> &lt; 0.001). Mild, moderate, and severe numbness strata were defined as &lt; 3, 3–6, and ≥ 7 using the walking anchor, and as &lt; 2, 2–4, and ≥ 5 using the CTCAE anchor. For the sensory subscale, the corresponding CPs were &lt; 2.50, 2.50–5.49, and ≥ 5.50 per the walking anchor, versus &lt; 0.83, 0.83–2.32, and ≥ 2.33 per the CTCAE anchor. For the interference subscale, stratification CPs were &lt; 2.00, 2.00–4.66, and ≥ 4.67 based on the walking anchor, and &lt; 1.67, 1.67–3.99, and ≥ 4.00 based on the CTCAE anchor. These subgroups displayed distinct longitudinal trajectories across the chemotherapy course.</p> Conclusion <p>The Chinese version of the TNAS is a valid and sensitive tool for TIPN assessment. Its established cutpoints provide a quantitative basis for defining responders in clinical trials and triggering early toxicity management.</p>

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Validation and cutpoints of the treatment-induced neuropathy assessment scale (TNAS) in Chinese cancer patients: a prospective cohort study

  • 期刊论文

  • 发表日期：

    2026年7月23日

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  • Chenxi He,
  • Wei Xu,
  • Jing Li,
  • Wenlin Wu,
  • Shi Wang,
  • Changjin Wu,
  • Yubo Zhang,
  • Yuxian Nie,
  • Feng Gao,
  • Qiuling Shi

摘要

Objective

Treatment-induced peripheral neuropathy (TIPN) significantly impairs patients’ quality of life, compromises the treatment process, and adversely affects prognosis. The aim of this study was to evaluate the psychometric properties of the Treatment-induced Neuropathy Assessment Scale (TNAS) and establish cutpoints in Chinese patients with cancer.

Methods

In a prospective cohort of 254 colorectal cancer patients receiving oxaliplatin, the TNAS was assessed for reliability and validity. Using patient-reported walking impairment and CTCAE grades as anchors, optimal cutpoints (CPs) for the numbness, sensory subscale, and interference subscale were derived. Group-Based Trajectory Modeling (GBTM) was subsequently used to examine the clinical utility of the cutpoints.

Results

The TNAS showed internal consistency (α = 0.92) and repeatability (ICC = 0.85) in Chinese patients. The scale significantly discriminated between patients with and without CTCAE-defined events (1.87 ± 1.60 vs. 1.15 ± 1.72, effect size = 0.44; P < 0.001). Mild, moderate, and severe numbness strata were defined as < 3, 3–6, and ≥ 7 using the walking anchor, and as < 2, 2–4, and ≥ 5 using the CTCAE anchor. For the sensory subscale, the corresponding CPs were < 2.50, 2.50–5.49, and ≥ 5.50 per the walking anchor, versus < 0.83, 0.83–2.32, and ≥ 2.33 per the CTCAE anchor. For the interference subscale, stratification CPs were < 2.00, 2.00–4.66, and ≥ 4.67 based on the walking anchor, and < 1.67, 1.67–3.99, and ≥ 4.00 based on the CTCAE anchor. These subgroups displayed distinct longitudinal trajectories across the chemotherapy course.

Conclusion

The Chinese version of the TNAS is a valid and sensitive tool for TIPN assessment. Its established cutpoints provide a quantitative basis for defining responders in clinical trials and triggering early toxicity management.