Predictive clinical factors of chronic peripheral neuropathy induced by oxaliplatin
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ORIGINAL ARTICLE
Predictive clinical factors of chronic peripheral neuropathy induced by oxaliplatin Nilgun Yildirim 1
&
Mahir Cengiz 2
Received: 21 November 2019 / Accepted: 17 January 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose We aimed to identify potential clinical parameters that can be easily obtained by a pre-treatment clinicopathological evaluation and whole blood test to estimate the development of oxaliplatin-induced peripheral neuropathy (OIPN). Methods This study was conducted retrospectively. For the FOLFOX regimen, patients received oxaliplatin, 85 mg/m2, every 2 weeks for 12 courses, and with the XELOX regimen, oxaliplatin was 130 mg/m2, every 3 weeks for 6–8 courses. The incidence and degree of neuropathy (NCI-CTCAE v.3) were recorded. Results A total of 186 patients were included in the study. There were 108 (58%) patients in the grade 0–1 (G0–G1) neuropathy group (mean age 50.5 ± 11.5; 63% men), and 78 (42%) patients in the grade 2–3 (G2–G3) neuropathy group (mean age 58.0 ± 10.8; 46.2% men). The relationship between G2–G3 OIPN development and age (p < 0.001), gender (p = 0.02), and ECOG performance status (p = 0.007) was statistically significant. In the G2–G3 neuropathy group, serum gamma-glutamyl transferase (GGT) (p < 0.001) and glucose (p = 0.007) levels were higher, whereas vitamin D (p < 0.001), hemoglobin (Hgb) (p < 0.001), serum albumin (p = 0.001), and serum magnesium (p = 0.035) levels were lower compared with the G0–G1 neuropathy group. G2–G3 neuropathy was observed in 88% of patients with mucinous carcinoma pathologic type (p < 0.001). Conclusion This study demonstrated that age, histopathologic type, albumin, GGT, glucose, vitamin D, and Hgb levels were the effective factors in prediction of the development of OIPN. In addition, GGT, vitamin D, and Hgb levels were the most effective factor to predict development of OIPN. Keywords Oxaliplatin . Peripheral neuropathy . Gastrointestinal system cancers . Treatment . Toxicity
Introduction Oxaliplatin, a third-generation platinum-based agent, is the main chemotherapeutic agent for the treatment of colorectal cancer (CRC), stomach, pancreatic cancer, and many other cancers types [1, 2]. Oxaliplatin with 5-fluorouracil and leucovorin (FOLFOX regimen) or capecitabine (Xelox regimen) is one of the important drugs in the adjuvant and
* Nilgun Yildirim [email protected] Mahir Cengiz [email protected] 1
Department of Medical Oncology, Firat University School of Medicine, Elazıg, Turkey
2
Department of Internal Medicine, Biruni University School of Medicine, İstanbul, Turkey
metastatic stage treatment of gastrointestinal system cancers. Oxaliplatin-induced peripheral neuropathy (OIPN) is one of the main problems associated with the use of this drug. In fact, oxaliplatin may cause acute neuropathy (transient, distal paresthesia during the first minutes of infusion or shortly after) and chronic sensory neuropathy (distal paresthesia and numbness may lead to functional disability in case of g
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