Background Oxaliplatin-related neurotoxicity is the main limitation for its continuation in adjuvant and palliative chemotherapy.
Purpose To evaluate oxaliplatin-related neurotoxicity in combination with other chemotherapeutic agents or radiation in the Department of Medical Oncology in our hospital.
Materials and methods Retrospective observational study of patients treated with oxaliplatin from January 2011–January 2013. Variables: demographics, cancer type, oxaliplatin-related neurotoxicity and its grade, chemotherapy regimens, dose, oxaliplatin dose reduction or discontinuation, initial and final ECOG and specific treatment.
Results Of the 243 patients studied 65.02% were male with an average age of 66.21 years (SD: 9.46). The 3 most commonly diagnosed types of cancer were: colon adenocarcinoma (45.27%), rectal adenocarcinoma (24.69%) and gastric adenocarcinoma (13.99%). Oxaliplatin caused neurotoxicity in 67.49% (164/243) of patients, being 16.05% (39/243) and 31.68% (77/243) grade 3 and 4, respectively. In the group of patients older than 70 years, 39.22% (40/102) presented neurotoxicity grade 4 (p = 0.01).
31.7% discontinued oxaliplatin treatment and 60.90% reduced the dose due to neurotoxicity. Of the 164 patients with neurotoxicity, performance status worsened by at least one point in 72.52%, using the ECOG scale. The percentage with a worse ECOG status increased to 76.8% and 87.01% in patients with neurotoxicity grade 3 and 4, respectively (p < 0.001). Only 10.28% (25/243) received Ca/Mg infusions to prevent the neurotoxicity, which was effective in 92% of them. Another preventive measure was to reduce the oxaliplatin infusion rate, applied in 5.34%, which was effective in all the cases. In no case was specific drug treatment prescribed to prevent or treat neurotoxicity.
Conclusions Oxaliplatin-related neurotoxicity may worsen the performance status and cause reduction or discontinuation of chemotherapy. This could be a limitation of its use. In the absence of additional studies, Ca/Mg infusions could decrease the incidence of oxaliplatin-related neurotoxicity.
No conflict of interest.
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