The impact of paclitaxel or cisplatin‐based chemotherapy on sympathetic skin response: a prospective study

Abstract

The current study aimed to assess the viability of sympathetic sudomotor fibers in cancer patients treated with cisplatin or paclitaxel-based chemotherapy and to ascertain whether this method could contribute to the diagnostic sensitivity of conventional techniques. Sympathetic skin response (SSR) from the hand and sole of 23 cancer patients (nine females and 14 males, mean age 62.4 +/- 10.5 years) was recorded unilaterally before and after chemotherapy with six courses of cumulative cisplatin or paclitaxel containing regimens. Clinical and electrophysiological data were also collected and correlated with the SSR results. Twenty-three healthy subjects served as controls. SSR abnormalities were only present in patients with evidence of peripheral neuropathy assessed by conventional nerve conduction techniques. Three patients had absent SSR in the upper limb whilst six patients had absent SSR both in the upper and lower limbs. In the upper limb, the mean SSR latency was not significantly altered through time (P = 0.086). In the lower limb the mean delay from baseline to follow-up was significantly changed (P = 0.029). In patients, the mean SSR latency was significantly prolonged compared with controls in both upper limb (P = 0.001) and lower limb (P = 0.000). SSR abnormalities were strongly related to sensory conduction abnormalities as detected by conventional techniques (r = 0.39, P = 0.004). Our results showed that SSR does not seem to add to the diagnostic sensitivity of conventional techniques in chemotherapy-induced neuropathy. However, its role in the disclosure of small fibers neuropathy abnormalities is worth considering. Further studies are warranted to address this important issue.

Impact of cancer and chemotherapy on autonomic nervous system function and cardiovascular reactivity in young adults with cancer: a case-controlled feasibility study

“…Acute and chronic autonomic impairments have deleterious effects on quality of life and survival in health and a variety of disease states [ 3 ]. Initial evidence of cancer- and chemotherapy-related ANS dysfunction have been shown here and in the literature (both during and post-treatment) [ 6 – 10 , 12 , 30 , 32 , 33 , 43 – 48 ]. However, the methodology in previous ANS-cancer research has been inconsistent.…”

“…In establishing our feasibility criteria (FC), several important factors were weighed. First, previous investigations of ANS function in cancer [ 6 , 8 – 10 , 12 , 13 , 30 – 33 ] often had small sample sizes, did not establish pre-treatment baselines, included a wide age-range of participants and lacked sufficient and consistent methodological and results reporting. Second, in accordance with pilot study guidelines [ 24 ], and given that our trial did not include an intervention, we established more stringent FC to reflect the factors that could hinder a larger, more definitive trial.…”

Neurophysiological, nerve imaging and other techniques to assess chemotherapy-induced peripheral neurotoxicity in the clinical and research settings

“…Hence, the authors concluded that sudomotor function is not preferentially affected than somatic fibres in CIPN. 38 Sudoscan, a non-invasive method to quantify the electrochemical skin conductance of limbs, has been applied in a single study enrolling 88 patients receiving various types of chemotherapy to assess sudomotor function to detect and follow-up CIPN. This study supported the use of Sudoscan to assess small fibre neuropathy in patients receiving chemotherapy, but results were too preliminary and obtained just from a single setting to be generalised.…”

Bioavailability of 99mTc‐Ha‐paclitaxel complex [99mTc‐ONCOFID‐P] in mice using four different administration routes

“…However, the therapeutic response with the commercial formulation is always associated with toxic side-effects because it contains Cremophor EL, a castor oil/ethanol solution, essential for the paclitaxel solubility but also responsible for most of the side-effects and adverse drug reactions. 2,3 Recently low molecular weight anticancer drugs have been linked to polymers such as hyaluronic acid [4][5][6] (HA), which provide advantages in drug pharmacokinetics 7 and suppresses their undesirable cytotoxic side-effects. HA is a linear polysaccharide formed by alternating D-glucoronic acid (GlcUA) and N-acetyl-D-Glucosamine (GlcNAc) units.…”