Abstract
Peripheral neuropathy is a major adverse event associated with oxaliplatin-based chemotherapy and is a major dose-limiting adverse event in clinical practice. However, some patients treated with oxaliplatin may show no or minimal peripheral neuropathy. These differences are still poorly understood. The data on patients with colorectal cancer who received oxaliplatin-based regimens between January 2005 and June 2010 at South Miyagi Medical Center were retrospectively retrieved from the medical records. We selected 51 patients, and factor analysis was performed. The serum chlorine (Cl) level at baseline was significantly higher in patients with a high frequency of peripheral neuropathy (106; range 104 - 107 vs. 104; range 101 - 104 mEq/L, p = 0.02). Principal component analysis showed the variables Cl, body mass index, status of liver metastasis, and status of lymph node metastasis were related to the incidence of peripheral neuropathy. Discriminant analysis showed the model had predicted 72.5% of peripheral neuropathy. An understanding of the patient’s characteristics could be useful for preventing or predicting oxaliplatin-induced peripheral neuropathy.
Highlights
Colorectal cancer treatment is performed by surgery/endoscope treatment and chemotherapy
The primary purpose of this study was to investigate the predictive factors associated with the incidence of oxaliplatin-induced peripheral neuropathy, which is a major adverse event of oxaliplatin-base chemotherapy and is the most frequent dose-limiting toxicity in clinical practice
51 patients treated with the oxaliplatin-based regimen were retrospectively analyzed, and peripheral neuropathy was observed in 45 patients (88.2%): 17 with grade 1 (33.1%), 23 with grade 2 (45.1%) and 5 with grade 3 (9.8%)
Summary
Colorectal cancer treatment is performed by surgery/endoscope treatment and chemotherapy. After chemotherapy with fluorouracil (5-FU) was first developed in 1957, 5-FU with a folic acid/leucovorin (LV) regimen based on a concept of biochemical modulation was used as standard therapy. Prolonged survival was achieved using combination therapies with folic acid, 5-FU and oxaliplatin (FOLFOX) or with folic acid, 5-FU and irinotecan (FOLFIRI) regimens. The efficacy against colorectal cancer has been enhanced by the development of molecular-targeted drugs such as bevacizumab, cetuximab and panitumumab [1,2,3,4,5]. Oxaliplatin [6], a third-generation platinum agent, is a key drug in the chemotherapy treatment of colorectal cancer. Many clinical trials with FOLFOX and XELOX (in combination with capecitabine and oxaliplatin) regimens have been shown to be useful.
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