26 P - Monitoring of neurotoxicity of taxanes

Abstract

Because the clinical use of taxanes migbt be limited by neurotoxicity, we have determined both clinical and electrophysiological neurological functions in 14 patients treated with paclitaxel/cisplatin (cumulative paclitaxel doses 175-1225 mg/m2, cumulative cisplatin doses 100-700 mg/m2) and in 6 patients treated with docetaxel (cumulative doses 100-400 mg/m2). Among the paclitaxel/cisplatin group, 12 patients developed sensory symptoms. Additional weakness was seen in 8 patients but motor nerve conduction studies of the peroneal nerve revealed impaired function in 13 patients. Three courses of docetaxel resulted in sensory neuropathy and a decrease in orthodromic sensory conduction velocity of the lateral plantar nerve in 3 patients. Docetaxel did not result in clinical motor neuropathy or altered motor nerve conduction of the peroneal nerve. In both groups, severity of clinical and electrophysiological neurotoxicity progrediently increased with cumulative drug doses. In conclusion, patients treated with paelitaxel/cisplatin developed sensory and motor neuropathy, whereas patients treated witb docetaxel only developed sensory neuropathy. Careful neurological and electrophysiological monitoring might allow to detect early symptoms of neurotoxicity and thus to avoid severe neurotoxicity.