P-10 Prevalence and risk factors of chronic neuropathy in 225 colorectal cancer patients treated with oxaliplatin-based regimens in Tunisia

Abstract

Oxaliplatin is largely used in colorectal cancers (CRC). A major side effect is acute and chronic peripheral neuropathy. The aim of our study was to evaluate the prevalence and risk factors of oxaliplatin-induced chronic neuropathy and to study the consequences on treatment observation. We conducted a retrospective study including patients with CRC treated in the oncology department of the military hospital of Tunis between January 2013 and December 2020. Patients were treated with oxaliplatin-based regimens: FOLFOX, FOLOFORINOX, and XELOX. Evaluation of neuropathy was done according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE V4). 225 patients were included. Median age was 58 years. Sex ratio was 1.32. 54% were aged above 60 years. 33% had diabetes. 64% presented neuropathy: 57% grade 1, 29% grade 2 and 14% grade 3. The average cumulative dose leading to the occurrence of neurotoxicity (all grades) was 510.32 mg/m2. We noted a correlation between diabetes, cumulative dose of oxaliplatin, and the incidence of chronic neuropathy. No correlation was found between sex, age, high BMI, chronic renal dysfunction, and neuropathy incidence. Neuropathy required a dose adjustment (a 25% decrease in the initial dose of oxaliplatin) in 32% of cases. Patients had to delay their treatment in 14.5% of cases. The discontinuation of oxaliplatin was decided in 16% of cases. The most prescribed treatment for neuropathy was pregabalin (74%), followed by carbamazepine (11.8%). Medication was not sufficient to stop neuropathy in 77.7% of cases. The incidence of chronic oxaliplatin-induced neuropathy was high and contributed to treatment delay and modification in many cases. Diabetes and cumulative dose of oxaliplatin were associated with chronic neuropathy.