Panagiotis Kokotis1, Martin Schmelz2, Efthymios Kostouros3, Nikolaos Karandreas4, Meletios-Athanasios Dimopoulos3. 1. First Department of Neurology, Aeginition Hospital, Laboratory of Clinical Neurophysiology, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: pkokotis@med.uoa.gr. 2. Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany. 3. Department of Clinical Therapeutics, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece. 4. First Department of Neurology, Aeginition Hospital, Laboratory of Clinical Neurophysiology, National and Kapodistrian University of Athens, Athens, Greece.
Abstract
BACKGROUND: Oxaliplatin is an effective drug used mainly for advanced colorectal cancer. Neurotoxicity is the major side effect of oxaliplatin. The present clinical and neurophysiologic study was conducted to evaluate patients receiving oxaliplatin therapy. PATIENTS AND METHODS: Thirty-one consecutive patients with colorectal cancer who received oxaliplatin therapy were followed up for more than 3 years. The patients underwent clinical and neurophysiologic tests for large and small fiber function at every visit. RESULTS: Most of the patients received oxaliplatin-based chemotherapy at the initial dose of 130 mg/m(2) for 6 to 8 cycles, normally every 3 weeks. Acute neurotoxicity with cold and mechanical hyperalgesia was reported by the vast majority of patients after each cycle of therapy and was confirmed by the quantitative sensory, filament, and axon reflex test. Chronic sensory cumulative neuropathy developed in most of the patients after the middle of therapy with numbness and was assessed using clinical scales, nerve conduction studies, and the vibration threshold. Our results support the persistence of the sensory nerve deficits for years after cessation of oxaliplatin therapy. CONCLUSION: Our study has confirmed the results of a few previous long-term studies concerning the persistence of chronic large sensory fiber neuropathy and the influence of the cumulative dose of oxaliplatin on the development and severity of the chronic neuropathy. Our findings have improved the knowledge about the acute oxaliplatin-induced neurotoxicity using the C-fiber axon reflex response.
BACKGROUND:Oxaliplatin is an effective drug used mainly for advanced colorectal cancer. Neurotoxicity is the major side effect of oxaliplatin. The present clinical and neurophysiologic study was conducted to evaluate patients receiving oxaliplatin therapy. PATIENTS AND METHODS: Thirty-one consecutive patients with colorectal cancer who received oxaliplatin therapy were followed up for more than 3 years. The patients underwent clinical and neurophysiologic tests for large and small fiber function at every visit. RESULTS: Most of the patients received oxaliplatin-based chemotherapy at the initial dose of 130 mg/m(2) for 6 to 8 cycles, normally every 3 weeks. Acute neurotoxicity with cold and mechanical hyperalgesia was reported by the vast majority of patients after each cycle of therapy and was confirmed by the quantitative sensory, filament, and axon reflex test. Chronic sensory cumulative neuropathy developed in most of the patients after the middle of therapy with numbness and was assessed using clinical scales, nerve conduction studies, and the vibration threshold. Our results support the persistence of the sensory nerve deficits for years after cessation of oxaliplatin therapy. CONCLUSION: Our study has confirmed the results of a few previous long-term studies concerning the persistence of chronic large sensory fiber neuropathy and the influence of the cumulative dose of oxaliplatin on the development and severity of the chronic neuropathy. Our findings have improved the knowledge about the acute oxaliplatin-induced neurotoxicity using the C-fiber axon reflex response.
Authors: Su Hyun Kim; Woojun Kim; Ji Hee Kim; Min Ki Woo; Ji Yeon Baek; Sun Young Kim; Seung Hyun Chung; Ho Jin Kim Journal: J Clin Neurol Date: 2018-01 Impact factor: 3.077
Authors: Anna Lethicia L Oliveira; Gisele G L Santos; Renan F Espirito-Santo; Gessica Sabrina A Silva; Afrânio F Evangelista; Daniela N Silva; Milena B P Soares; Cristiane Flora Villarreal Journal: Stem Cells Int Date: 2021-01-06 Impact factor: 5.443