Background Oxaliplatin is widely used in the treatment of solid cancers. The main limit of use is the occurrence of peripheral neuropathy (PN). The principal predisposing risk factors (RF) are: diabetes, chronic alcoholism, cumulative dose, malnutrition, history of gastrointestinal surgery (malabsorption of neuroprotectors such as the vitamin B12), anaemia, kidney failure and concomitant neurotoxic drugs.
Purpose To analyse these RFs and to determine a relationship between the number of RFs and the average cumulative dose (ACD) of oxaliplatin.
Material and methods Retrospective 2-year study (2011–2012), n = 96 patients. The RFs mentioned above were identified from patients’ records. From the chemotherapy software Asclepios we identified the total cumulative dose and the threshold dose for occurrence of PN for each patient. The tests used were the Pearson correlation coefficient and Student’s significance test.
Results The incidence of PN in our sample was 46%. 3 groups were identified: 0–1 RF (59%), 2 RF (27%), 3 RF or more (11%). The proportion for each RF was: anaemia (48%), malnutrition and antecedents of gastrointestinal surgery (40%), diabetes (16%), administration of neurotoxic drugs before or during chemotherapy (16%) and chronic alcoholism (13%). The ACD at the onset of clinical signs was 331 mg/m². According to the Summary of Product Characteristics the cumulative dose is 850 mg/m². In our sample it was 2.6 times smaller (p < 0). For each group it was 360 mg/m² in the 0–1 RF group, 250 mg/m²0 in the 2 RFs group and 215 mg/m² in the 3 RFs or more. It was inversely proportional to the number of RFs (r = -0.930) (p = 0.069).
Conclusion It has been shown that the greater the number of RFs, the lower the ACD at which PN occurs. According to the literature these RFs do not contraindicate the use of oxaliplatin and in practice the reducing or stopping of oxaliplatin is dictated by the clinical appearance of NP.
References and/or acknowledgements No conflict of interest.
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