Abstract
8177 Background: Oxaliplatin dose-limiting toxicity (DLT) is the chronic cumulative neurotoxicity; it can be moderate (grade 2) or severe (grade 3 - NCI criteria). Grade 3 neurotoxicity leads to functional limitation that forces us to stop the treatment. Grade 3 toxicity involves 3% of the patients treated with 510–765 mg/m2 of oxaliplatin, 15–28% of those treated with 765-1020 mg/m2 and 50% of those treated with over 1020 mg/m2(Gamelin E, Semin Oncol, 29: 21–33, 2002). We conduced a multicentric study to evaluate GSH activity to prevent chronic cumulative neurotoxicity of oxaliplatin. Methods: From 01/2003 to 11/2004 we evaluated 92 patients (58 males, 34 females) whose median age was 65 (range 33–78). They were affected by: colorectal carcinoma (77 pts), cholangio or pancreatic carcinoma (10 pts), gastric carcinoma (3 pts), NHL (2 pts). These patients were submitted to chemotherapy containing oxaliplatin as adiuvant or as first, second, third or fourth line therapy as per following schedules: monochemotherapy, FOLFOX 4, FOLFOX 6, GEMOX, capecitabine plus oxaliplatin. We gave all these patients GSH (1500 mg/m2 in 500 ml saline solution) 30 minutes before oxaliplatin infusion. According to NCI criteria Neurotoxicity was evaluated at every therapy cycle. Results: chronic cumulative neurotoxixity incidence is reported in the following table. Conclusions: Our experience is still limited and preliminary, but GSH seems to be able to prevent oxaliplatin chronic cumulative neurotoxicity, reducing grade 3 toxicity percentage in comparison with that expected; thus chemotherapy can go on without delay or therapy stop. Anyway further randomized and controlled studies are necessary. No significant financial relationships to disclose.
Published Version
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