J Clin Neurol.  2018 Jan;14(1):81-89. 10.3988/jcn.2018.14.1.81.

A Prospective Study of Chronic Oxaliplatin-Induced Neuropathy in Patients with Colon Cancer: Long-Term Outcomes and Predictors of Severe Oxaliplatin-Induced Neuropathy

Affiliations
  • 1Department of Neurology, Research Institute and Hospital, National Cancer Center, Goyang, Korea. hojinkim@ncc.re.kr
  • 2Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
  • 3Rehabilitation Clinic, Research Institute and Hospital, National Cancer Center, Goyang, Korea. shchung@ncc.re.kr

Abstract

BACKGROUND
AND PURPOSE: The objective of this study was to determine the incidence and long-term outcomes of oxaliplatin-induced peripheral neuropathy (OIPN), as well as predictors of its severe form.
METHODS
Sixty-nine patients who were taking oxaliplatin for colon cancer were prospectively followed prior to starting chemotherapy and after 4, 8, and 12 cycles of chemotherapy. Thirty-six patients completed the follow-up at 1 year after the end of chemotherapy. The patients were assessed using clinical assessment scales and nerve conduction studies (NCS) at each follow-up visit.
RESULTS
By applying the National Cancer Institute Common Toxicity criteria, OIPN was classified as grade 1 in 30 (44%) patients, grade 2 in 25 (36%), and grade 3 in 10 (14%) at the completion of therapy. At 1 year after the treatment, OIPN of grades 1, 2, and 3 was found in 50, 3, and 11% of the patients, respectively. Multivariate analysis showed that reductions of the amplitude of the sensory action potential of >11.5% in the median nerve between baseline and four cycles of chemotherapy (odds ratio=5.603, p=0.031) and of >22.5% in the sural nerve between four and eight cycles of chemotherapy (odds ratio=5.603, p=0.031) were independently associated with the risk of developing grade-3 OIPN.
CONCLUSIONS
While the severity of OIPN can improve after oxaliplatin discontinuation, more than half of the patients in this study still had OIPN at 1 year after discontinuation. Early changes in the NCS results for sensory nerves can predict the development of severe OIPN during treatment.

Keyword

oxaliplatin; oxaliplatin-induced peripheral neuropathy; colon cancer; predictor
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