Modern therapy has improved survival for children with cancer. However, treatment has
unintended consequences. Depending on the neurotoxic agent (platinum derivates or
vinca-alkaloids), 52%-100% of children develop a peripheral neuropathy. Diagnosis is
underreported and its impact as potentially initial cause for many sensory and motor symptoms
underestimated. The severe symptoms such as loss of sensation, numbness, pain, absent
reflexes as well as loss of balance control not only delays motor development milestones such
as walking, running, jumping or climbing, diminishing children's quality of life and
affecting their social reintegration, but is also of high clinical relevance. Additionally,
recovery is poor and there are currently no effective options to prevent or treat the
symptoms of Chemotherapy-induced peripheral neuropathy (CIPN). Promising results have so far
been achieved with specific exercise interventions.
The investigators would therefore like to conduct a prospective, multicenter, two-armed trial
(RCT with follow-up). Patients N=131 will be recruited from 7 centers: University Children's
Hospital of Basel, the Inselspital Bern, Kantonsspital Aarau, Children Hospital for Eastern
Switzerland St. Gallen, University Children Hospital Freiburg and the National Center for
tumor diseases (NCT), University Children Hospital Heidelberg, Charité Berlin. All patients
(and their guardians) scheduled to receive chemotherapy containing either a platinum derivate
or vinca-alkaloid, will be asked to participate. Willing patients will then be randomized
either into an intervention group or a control group (CG). Patients in the intervention group
will perform a standardized, age-adjusted, specific playful sensorimotor training (SMT)
program twice a week for the duration of their medical therapy, in addition to usual care,
while the control group receives treatment as usual. The CG will be given the opportunity to
participate in the intervention after therapy. Data will be assessed at 3-4 time points:
Prior to chemotherapy (baseline T0), after 12 weeks (T1), after completion of therapy for
children that are treated >3 months (Tp) and after 12 months follow-up (T3). Additionally,
status of CIPN reported symptoms will be monitored twice in-between (6 weeks). The
investigators hypothesize that less children in the intervention group will develop symptoms
of CIPN (TNS score) with its debilitating side-effects. Furthermore, children in the
intervention group will be able to maintain relevant motor and sensory functions and their
associated physical functions which will enable them to receive their planned medical therapy
but also to stay on the age-appropriate motor development level, improve their quality life
and enhance social reintegration after therapy.