Chemotherapy-Induced Peripheral Neuropathy (CIPN) in Patients Receiving 4-6 Cycles of Platinum-Based and Taxane-Based Chemotherapy: A Prospective, Single-Center Study from Kosovo

Abstract

Background Chemotherapy-induced peripheral neuropathy (CIPN) is most commonly associated with platinum-based drugs, taxanes, and vinca alkaloids. This prospective study from a single center in Kosovo aimed to evaluate CIPN in 120 patients receiving 4–6 cycles of platinum-based and taxane-based chemotherapy. Material/Methods One hundred twenty patients underwent neurological examination and nerve conduction studies (NCS) before chemotherapy, and after 4 to 6 cycles of treatment. Sixty patients were treated with platinum-based chemotherapy, 30 were treated with taxane-based chemotherapy, and 22 patients received a combination of platinum- and taxane-based chemotherapy. The most commonly used platinum-based compounds were oxaliplatin and carboplatin, whereas the most commonly used taxane medications were paclitaxel and docetaxel. Presence of neuropathy was confirmed with neurological examination of electrophysiological criteria applicable for polyneuropathies. Total Neuropathy Score (TNSr) was used to combine clinical and electrophysiological values. Results Around 90% of patients self-reported neuropathic symptoms, and in 60% of them polyneuropathy was present in NCS. All sensory and motor nerves had significantly lower amplitudes ( P <0.01). Platinum-based agents caused more pronounced decrease in ulnar nerve compound motor action potential (CMAP) ( P <0.05); when used solely or in combination with taxanes, they caused significant decrease in tibial nerve CMAP ( P <0.01). TNSr did not reach statistical significance between groups; only clinical muscle strength showed pronounced weakness in the combined protocol ( P <0.05). Conclusions These findings support previous studies and show that CIPN, including sensory and motor symptoms, is commonly associated with chemotherapy. Platinum-based chemotherapy agents were more commonly associated with ulnar and tibial nerve damage in this study population.

Current understanding of the molecular mechanisms of chemotherapy-induced peripheral neuropathy

“…The severity of CIPN symptoms demonstrated a strong correlation with the extent of reduction in SNAP measured from the sural nerves ( Matsuoka et al, 2016 ). Similarly, significant reductions in SNAP amplitudes and NCV were observed in the median nerves, ulnar nerves and sural nerves of patients treated with CIPN-causing agents ( Myftiu et al, 2022 ). Consistent with clinical observations, we and others detected a marked reduction in SNAP amplitudes and NCV from the caudal tail nerve in paclitaxel-treated or vincristine-treated mice ( Chine et al, 2019a , b ; Bosanac et al, 2021 ).…”