Correlation between nerve conduction velocity abnormality patterns and clinical severity grading in chemotherapy-induced peripheral neuropathy: a retrospective cohort study.

Objective: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating adverse effect of neurotoxic chemotherapy, yet the longitudinal relationship between nerve conduction study (NCS) changes and clinical severity remains insufficiently defined. Methods: In this retrospective cohort of 186 patients undergoing serial clinical and electrophysiological assessment at baseline, mid-treatment, end-of-treatment, and follow-up, sural sensory nerve action potential (SNAP) amplitude showed the strongest inverse association with end-of-treatment NCI-CTCAE severity ( Results: Absolute end-of-treatment sural SNAP amplitude identified Grade ≥2 CIPN with an area under the curve (AUC) of 0.856, while a relative decline from baseline of ≥35% yielded an AUC of 0.872. Patients requiring neurotoxicity-related dose modification had larger early sural SNAP reductions from baseline to mid-treatment than those without treatment change (34.8% ± 13.2% vs. 17.6% ± 11.4%, Conclusions: These findings support serial large-fiber NCS, particularly sural SNAP amplitude and its percentage change from baseline, as objective correlates of CIPN severity and treatment tolerance in routine clinical practice.