A Prospective Study of Chronic Oxaliplatin-Induced Neuropathy in Patients with Colon Cancer: Long-Term Outcomes and Predictors of Severe Oxaliplatin-Induced Neuropathy
Journal of Clinical Neurology 2018³â 14±Ç 1È£ p.81 ~ p.89
±è¼öÇö(Kim Su-Hyun) - National Cancer Center Research Institute and Hospital Department of Neurology
±è¿ìÁØ(Kim Woo-Jun) - National Cancer Center Research Institute and Hospital Department of Neurology
±èÁöÈñ(Kim Ji-Hee) - National Cancer Center Research Institute and Hospital Department of Neurology
(Woo Min-Ki) - National Cancer Center Research Institute and Hospital Department of Neurology
¹éÁö¿¬(Baek Ji-Yeon) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
±è¼±¿µ(Kim Sun-Young) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
Á¤½ÂÇö(Chung Seung-Hyun) - National Cancer Center Research Institute and Hospital Rehabilitation Clinic
±èÈ£Áø(Kim Ho-Jin) - National Cancer Center Research Institute and Hospital Department of Neurology
Abstract
Background and Purpose: The objective of this study was to determine the incidence and long-term outcomes of oxaliplatin-induced peripheral neuropathy (OIPN), as well as predictors of its severe form.
Methods: Sixty-nine patients who were taking oxaliplatin for colon cancer were prospectively followed prior to starting chemotherapy and after 4, 8, and 12 cycles of chemotherapy. Thirty-six patients completed the follow-up at 1 year after the end of chemotherapy. The patients were assessed using clinical assessment scales and nerve conduction studies (NCS) at each follow-up visit.
Results: By applying the National Cancer Institute Common Toxicity criteria, OIPN was classified as grade 1 in 30 (44%) patients, grade 2 in 25 (36%), and grade 3 in 10 (14%) at the completion of therapy. At 1 year after the treatment, OIPN of grades 1, 2, and 3 was found in 50, 3, and 11% of the patients, respectively. Multivariate analysis showed that reductions of the amplitude of the sensory action potential of >11.5% in the median nerve between baseline and four cycles of chemotherapy (odds ratio=5.603, p=0.031) and of >22.5% in the sural nerve between four and eight cycles of chemotherapy (odds ratio=5.603, p=0.031) were independently associated with the risk of developing grade-3 OIPN.
Conclusions: While the severity of OIPN can improve after oxaliplatin discontinuation, more than half of the patients in this study still had OIPN at 1 year after discontinuation. Early changes in the NCS results for sensory nerves can predict the development of severe OIPN during treatment.
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oxaliplatin, oxaliplatin-induced peripheral neuropathy, colon cancer, predictor
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After oxaliplatin discontinuation, more than half of the patients in this study still had OIPN at 1 year after discontinuation.