Incidence of Cold-Induced Peripheral Neuropathy and Dose Modification of Adjuvant Oxaliplatin-Based Chemotherapy for Patients with Colorectal Cancer

Altaf, Rahim; Brixen, Annette Lund; Kristensen, Bent Bruun; Nielsen, Svend Erik

doi:10.1159/000362668

Cited by 25 publications

(18 citation statements)

References 11 publications

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“…An assessment of the quality of the 15 included studies was conducted based on criteria adapted from a previously published systematic review on oxaliplatin‐induced peripheral neuropathy and the STROBE Statement checklist (Table ). Only three studies were prospective, and the majority of studies failed to distinguish the acute and chronic forms of oxaliplatin‐induced peripheral neuropathy (Table ) . Seven studies investigated independent risk or prognostic factors by multivariate analyses .…”

Section: Resultsmentioning

confidence: 99%

Factors associated with the development and severity of oxaliplatin‐induced peripheral neuropathy: a systematic review

Pulvers

Marx

2017

Asia-Pac J Clncl Oncology

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Oxaliplatin is a platinum-derivative chemotherapeutic agent used for colorectal cancer in the adjuvant and metastatic setting in combination with folinic acid and 5-fluorouracil. Oxaliplatin causes an acute cold-induced neurotoxicity and a chronic cumulative neuropathy, which can require dose modification and impact quality of life. To date, no prevention and treatment strategies have proved effective thus reinforcing the importance of identifying at-risk patients in order to maximize therapeutic benefit while minimizing neurotoxicity. Here we reviewed studies on risk and prognostic factors associated with the development and severity of oxaliplatin-induced peripheral neuropathy. A systematic search was conducted in MEDLINE and Embase, and studies investigating clinical and patient-related factors associated with oxaliplatin-induced peripheral neuropathy as their primary focus were identified, and quantitative data were extracted when available. We identified 15 studies, of which only three were prospective. Notable factors were acute neurotoxicity symptoms predicting chronic neuropathy, baseline laboratory findings, patient demographics such as age and gender, comorbidities, and environmental factors. No factor was consistently identified across multiple studies other than the association with oxaliplatin dose. Further investigation into these factors may yield insight into potential neuropathy prevention and treatment strategies.

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Section: Resultsmentioning

confidence: 99%

Factors associated with the development and severity of oxaliplatin‐induced peripheral neuropathy: a systematic review

Pulvers

Marx

2017

Asia-Pac J Clncl Oncology

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“…Contrasting evaluations were discussed and resolved by all investigators. Modifications in the OXA dose , in case of neurotoxicity, were applied as reported before [11]. …”

Section: Methodsmentioning

confidence: 99%

Diabetes and Body Mass Index Are Associated with Neuropathy and Prognosis in Colon Cancer Patients Treated with Capecitabine and Oxaliplatin Adjuvant Chemotherapy

Ottaiano¹,

Nappi²,

Tafuto³

et al. 2016

Oncology

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Background: There are few background data on the impact of clinical factors on neurotoxicity and prognosis in patients treated with adjuvant capecitabine and oxaliplatin (CAPOX) chemotherapy. Methods: 102 stage II high-risk and stage III colorectal cancer patients were treated for 6 months with adjuvant CAPOX, then they were followed up. Associations between clinical variables, metabolic syndrome components, smoking and neurotoxicity were evaluated by the χ² test. The Kaplan-Meier product limit method was applied to graph disease-free survival (DFS). Univariate analysis was done with the log-rank test. Cox's proportional hazards regression was used to analyze the effect of several risk factors on DFS. Results: Significant associations were found between diabetes (p < 0.001), BMI (p = 0.01) and the occurrence of chronic neurotoxicity. After a median follow-up of 46 months, 14 patients (13.7%) had suffered recurrence. An analysis of the prognostic factors for DFS showed that prognosis is unfavorable for patients with high lymph-nodal involvement (HR: 5.23, p = 0.0007), diabetes (HR: 4.86; p = 0.03) and a BMI ≥25 (HR: 3.69, p = 0.002). Discussion: Common mediators in diabetes and obesity could be involved in peripheral neuropathy and in stimulating micro-metastases. Further studies are necessary to explain this interesting connection between diabetes, obesity and colon cancer.

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“…In some cases, OIPN severity may require prolongation of oxaliplatin administration time, dose reduction, treatment delay, or drug discontinuation to avoid irreversible sensory nerve damage 19–21 , although evaluation of such management approaches in clinical trials have not resulted in reduced OIPN severity 22 .…”

Section: Introductionmentioning

confidence: 99%

Oxaliplatin-Induced Peripheral Neuropathy and Identification of Unique Severity Groups in Colorectal Cancer

Griffith

Zhu

Johantgen

et al. 2017

Journal of Pain and Symptom Management

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Context Oxaliplatin-induced peripheral neuropathy (OIPN) is a dose limiting toxicity of oxaliplatin and affects most colorectal cancer (CRC) patients. OIPN is commonly evaluated by patient symptom report, using scales to reflect impairment. They do not discriminate between unique grouping of symptoms and signs, which impedes prompt identification of OIPN. Objective Our study objective was to identify clusters of symptoms and signs that differentiated underlying clinical severity and segregated patients within our population into OIPN subgroups. Methods Chemotherapy naïve CRC patients (N=148) receiving oxaliplatin were administered the Total Neuropathy Score clinical (TNSc©), which includes symptom report (sensory, motor, autonomic) and sensory examination (pin sense, vibration, reflexes). The TNSc© was administered prior to chemotherapy initiation (T0), and following cumulative doses of oxaliplatin 510-520 mg/m2 (T1) and 1020-1040 mg/m2 of oxaliplain (T2). Using mean T2 TNSc© scores, latent class analysis (LCA) grouped patients into OIPN severity cohorts. Results LCA categorized patients into 4 distinct OIPN groups: low symptoms and low signs (N=54); low symptoms and intermediate signs (n=44); low symptoms and high signs (n=21); and high symptoms and high signs (n=29). No differences were noted among OIPN groups on age, sex, chemotherapy regimen, or cumulative oxaliplatin dose. Conclusion We identified OIPN patient groups with distinct symptoms/signs, demonstrating variability of OIPN presentation regardless of cumulative oxaliplatin dose. Over half of the sample had positive findings on OIPN examination despite little or no symptoms. Sensory examination of all patients receiving oxaliplatin is indicated for timely identification of OIPN, which will allow earlier symptom management.

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Incidence of Cold-Induced Peripheral Neuropathy and Dose Modification of Adjuvant Oxaliplatin-Based Chemotherapy for Patients with Colorectal Cancer

Cited by 25 publications

References 11 publications

Factors associated with the development and severity of oxaliplatin‐induced peripheral neuropathy: a systematic review

Factors associated with the development and severity of oxaliplatin‐induced peripheral neuropathy: a systematic review

Diabetes and Body Mass Index Are Associated with Neuropathy and Prognosis in Colon Cancer Patients Treated with Capecitabine and Oxaliplatin Adjuvant Chemotherapy

Oxaliplatin-Induced Peripheral Neuropathy and Identification of Unique Severity Groups in Colorectal Cancer

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