Abstract
Introduction: Oxaliplatin is a platinum-derivative chemotherapeutic agent used in digestive tumours, in the adjuvant and metastatic setting. Oxaliplatin can cause a chronic peripheral sensory neuropathy which impacts the quality of life and is dose limiting. To date, no therapeutic strategies have proved effective in the treatment of oxaliplatin-induced peripheral neuropathy (OIPN). Methods: A computerized search of the literature on PubMed database was performed. Publisher original articles were included if they focused on treatment of peripheral neuropathy among patients submitted to oxaliplatin. Eleven out of 242 reviewed papers met our inclusion criteria and were subjected to a 19-item quality checklist. Results: The included studies differed with respect to study design, patient population and sample size, neuropathic symptoms assessment and efficacy measure. Most studies had an adequate quality. Ten trials tested one drug, and one pilot study tested a non-pharmacological treatment—the neurofeedback. Of these, 3 trials included only patients submitted to oxaliplatin-based chemotherapy. Duloxetine showed moderate efficacy in 3 trials. Topical treatment with capsaicin or 10% amitriptyline was promisors in 2 single-arm trials with a few samples. Conclusion: In the last decade, there wasn’t an improvement in the treatment of chronic OIPN. The duloxetine is the unique drug with moderate efficacy on the treatment of OIPN. There is insufficient evidence to support a recommendation for any other treatment.
Highlights
Oxaliplatin is a platinum-derivative chemotherapeutic agent used in digestive tumours, in the adjuvant and metastatic setting
There is insufficient evidence to support a recommendation for any other treatment
Studies that met the following criteria were included: 1) if chemotherapy-induced peripheral neuropathy (CIPN) was assessed among cancer patients treated with oxaliplatin; 2) if the study focus is the treatment of CIPN; 3) if the publication was an original study; 4) if they were published in peer-reviewed journals and, 5) if they were written in English
Summary
Oxaliplatin is a platinum-derivative chemotherapeutic agent used in digestive tumours, in the adjuvant and metastatic setting. No therapeutic strategies have proved effective in the treatment of oxaliplatin-induced peripheral neuropathy (OIPN). Publisher original articles were included if they focused on treatment of peripheral neuropathy among patients submitted to oxaliplatin. Oxaliplatin-induced peripheral neuropathy (OIPN) occurs in two distinct forms: an acute neurotoxicity and a chronic cumulative sensory neuropathy [3] [4] [5] [6]. Acute symptoms manifest as a cold-precipitated tingling distal paraesthesia and pain, perioral paresthesias and muscle cramps, in approximately 80% of patients. These symptoms occur within hours or days after oxaliplatin course and typically resolve within a week of infusion [7].
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