Peripheral neurotoxicity of oxaliplatin in combination with 5-fluorouracil (FOLFOX) or capecitabine (XELOX): A prospective evaluation of 150 colorectal cancer patients

A. A. Argyriou, R. Velasco, C. Briani, G. Cavaletti, J. Bruna, P. Alberti, M. Cacciavillani, S. Lonardi, C. Santos, D. Cortinovis, M. Cazzaniga, H. P. Kalofonos

Research output: Contribution to journalArticlepeer-review

Abstract

Background: To report our prospective experience on the incidence and pattern of oxaliplatin (OXA)-induced peripheral neuropathy (OXA-IPN) in patients with colorectal cancer (CRC) treated with either FOLFOX-4 or XELoda + OXaliplatin (XELOX). Patients and methods: One hundred and fifty patients scheduled to be treated with either FOLFOX or XELOX for CRC were prospectively monitored at baseline and followed-up during chemotherapy. The incidence and severity of symptoms secondary to OXA-IPN were recorded using three different types of assessment, i.e. the motor and neurosensory National Cancer Institute common toxicity criteria, version 3.0 (NCI-CTCv3), the clinical version of thetotal neuropathy score (TNSc) and electrophysiological scores. Results: Patients treated with either FOLFOX-4 or XELOX manifested similar incidence rates and severities of acute OXA-IPN. However, FOLFOX-4 was associated with increased incidence of chronic neurotoxicity, compared with XELOX-treated patients (n = 64/77 versus 44/73; P = 0.002), at a very similar OXA median cumulative dose during both regimens. Both the NCI-CTCv3 and TNSc demonstrated that the severity of cumulative OXA-IPN in FOLFOX-4-treated patients is higher than in those treated with XELOX. Conclusion: The incidence of acute neurotoxicity during FOLFOX-4 therapy is similar to XELOX. However, it seems that FOLFOX-4 is more neurotoxic than XELOX in terms of cumulative OXA-IPN, despite comparable OXA cumulative dose.

Original languageEnglish
Article numbermds208
Pages (from-to)3116-3122
Number of pages7
JournalAnnals of Oncology
Volume23
Issue number12
DOIs
Publication statusPublished - Dec 2012

Keywords

  • Folfox-4
  • Incidence
  • Oxaliplatin
  • Peripheral neurotoxicity
  • Xelox

ASJC Scopus subject areas

  • Oncology
  • Hematology

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