TY - JOUR
T1 - Early predictors of oxaliplatin-induced cumulative neuropathy in colorectal cancer patients
AU - Velasco, Roser
AU - Bruna, Jordi
AU - Briani, Chiara
AU - Argyriou, Andreas A.
AU - Cavaletti, Guido
AU - Alberti, Paola
AU - Frigeni, Barbara
AU - Cacciavillani, Mario
AU - Lonardi, Sara
AU - Cortinovis, Diego
AU - Cazzaniga, Marina
AU - Santos, Cristina
AU - Kalofonos, Haralabos P.
PY - 2014
Y1 - 2014
N2 - Objectives: Peripheral neuropathy ranks among the most common dose-limiting and disabling side-effect of oxaliplatin (OXA)-based chemotherapy. The aim of this prospective, multicentre study was to define early clinical and neurophysiological markers that may help to identify patients at risk of developing severe, treatment emergent, cumulative OXA-induced peripheral neuropathy (OXAIPN). Methods: 200 colorectal cancer patients, scheduled to receive OXA-based chemotherapy, were prospectively followed. Detailed neurological assessment employing the clinical Total Neuropathy Score (TNSc), oncological rating scales (National Common Institute-Common Toxicity Criteria V.3) and nerve conduction studies (NCS) were performed at baseline, mid-treatment and at the end of chemotherapy. Symptoms of OXA-induced acute neurotoxicity were systematically recorded. Results: According to TNSc, 36 (18%) patients developed grade 3 OXAIPN. These patients were predominantly men ( p=0.005), presented a significant decrease in all NCS (p30% decrease in sensory nerve action potential amplitude from the baseline value in radial (OR 41.4; CI 95% 4.98 to 343.1; p=0.001) and dorsal sural nerves (OR 24.96; CI 95% 2.6 to 239.4; p=0.005) were independently associated with the risk of developing severe OXAIPN. Conclusions: High-grade OXA neurotoxicity can be predicted by clinical and neurophysiological information obtained at mid-treatment. Neurological assessment of acute neuropathy symptoms and radial and dorsal sural nerves NCS should be carefully monitored to predict and hopefully prevent the induction of severe OXAIPN.
AB - Objectives: Peripheral neuropathy ranks among the most common dose-limiting and disabling side-effect of oxaliplatin (OXA)-based chemotherapy. The aim of this prospective, multicentre study was to define early clinical and neurophysiological markers that may help to identify patients at risk of developing severe, treatment emergent, cumulative OXA-induced peripheral neuropathy (OXAIPN). Methods: 200 colorectal cancer patients, scheduled to receive OXA-based chemotherapy, were prospectively followed. Detailed neurological assessment employing the clinical Total Neuropathy Score (TNSc), oncological rating scales (National Common Institute-Common Toxicity Criteria V.3) and nerve conduction studies (NCS) were performed at baseline, mid-treatment and at the end of chemotherapy. Symptoms of OXA-induced acute neurotoxicity were systematically recorded. Results: According to TNSc, 36 (18%) patients developed grade 3 OXAIPN. These patients were predominantly men ( p=0.005), presented a significant decrease in all NCS (p30% decrease in sensory nerve action potential amplitude from the baseline value in radial (OR 41.4; CI 95% 4.98 to 343.1; p=0.001) and dorsal sural nerves (OR 24.96; CI 95% 2.6 to 239.4; p=0.005) were independently associated with the risk of developing severe OXAIPN. Conclusions: High-grade OXA neurotoxicity can be predicted by clinical and neurophysiological information obtained at mid-treatment. Neurological assessment of acute neuropathy symptoms and radial and dorsal sural nerves NCS should be carefully monitored to predict and hopefully prevent the induction of severe OXAIPN.
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U2 - 10.1136/jnnp-2013-305334
DO - 10.1136/jnnp-2013-305334
M3 - Article
C2 - 23813745
AN - SCOPUS:84895820491
VL - 85
SP - 392
EP - 398
JO - Journal of Neurology, Neurosurgery and Psychiatry
JF - Journal of Neurology, Neurosurgery and Psychiatry
SN - 0022-3050
IS - 4
ER -