Can Cobalamin prevent Oxaliplatin induced peripheral neuropathy?

Abstract

Background and objectives:Peripheral neuropathy induced by oxaliplatin is one of the main reasons for discontinuing chemotherapy. In this article, we evaluated the role of vitamin B12 in the prevention of oxaliplatin-induced peripheral neuropathy. Methods: A prospective randomized interventional study was done from 1st January 2018 to 30th De- cember 2018, in which patients who were diagnosed with gastrointestinal cancer in Rizgary and Nanakali teaching hospitals that have been scheduled to receive oxaliplatin-based regimen were enrolled. Patients were divided into two groups: control group received chemotherapy only and prophylaxis group received chemotherapy with vitamin B12; each group included fifteen patients with no significant differences between the groups regarding age and gender. The prophylaxis group received vitamin B12 injection in scheduled periods. All Patients received at least a cumulative dose of 500 mg/m2 of oxaliplatin. Patients were evaluated by nerve conduction study, B12 level, and other laboratory tests. Results: Twenty-one patients completed the study. There was a significant decrease in the serum vitamin B12 level (601.84±398.43 to 363±337.31) post-chemotherapy among the control group. Among the prophylaxis group, the mean value of serum vitamin B12 increased significantly after chemotherapy. To summarize, there was a significant decrease in the amplitude of nerve conduction study in the control group as compared to the prophylaxis group espe- cially in left (11.85±6.84 to 8.14±5.36) and right (14.01±6.05 to 9.52±6.08) Sural nerves. Conclusions:Vitamin B12 injection had an important role in the prevention of development of chronic oxaliplatin-induced peripheral neuropathy.