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Erschienen in: Journal of Cancer Research and Clinical Oncology 9/2018

28.06.2018 | Original Article – Clinical Oncology

Rechallenge with oxaliplatin and peripheral neuropathy in colorectal cancer patients

verfasst von: Sarah Besora, Cristina Santos, Cristina Izquierdo, Maria Mercedes Martinez-Villacampa, Jordi Bruna, Roser Velasco

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 9/2018

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Abstract

Background

Oxaliplatin (OXA) is a cornerstone in the treatment of colorectal cancer (CRC). Retreatment with OXA is frequently considered as salvage treatment. OXA-induced neuropathy (OIN) is the most frequent and feared long-term side effect.

Patients and methods

CRC patients receiving at least twice OXA-based chemotherapy lines at our institution between June 2000 and July 2016 were reviewed. The aim of this study was to investigate whether retreatment with OXA increases the risk of developing new or worsening previous neuropathy. OIN was assessed by National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI), Total Neuropathy Score© (TNS) and nerve-conduction studies.

Results

106 patients were included in the analysis. Median age at OXA-based retreatment was 61.5 (20–83) years. After the first OXA-based chemotherapy treatment, 63.4% of patients developed OIN, 30.7 and 8.9% grades 2 and 3, respectively, after a median of 11 (1–17) cycles. After 30 (11–90) months of median to retreatment with a median of 8 (1–14) OXA cycles, 39.6, 22.6, and 0% of patients developed grade 1, 2, and 3 OIN, respectively. Worsening of the previous OIN was observed in one-third (31.1%) of all patients. OXA-cumulative dose was independently associated with greater risk of worsening OIN (p < 0.001). Non-significant trend towards higher TNSc© scores after retreatment was observed [5 (0–11) vs 6 (3–13), p = 0.083].

Conclusion

Retreatment with OXA in CRC patients is a feasible option even in patients who previously developed moderate or severe OIN. One-third of patients’ OIN was worsened by retreatment. Neurological monitoring should be considered.
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Metadaten
Titel
Rechallenge with oxaliplatin and peripheral neuropathy in colorectal cancer patients
verfasst von
Sarah Besora
Cristina Santos
Cristina Izquierdo
Maria Mercedes Martinez-Villacampa
Jordi Bruna
Roser Velasco
Publikationsdatum
28.06.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Cancer Research and Clinical Oncology / Ausgabe 9/2018
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-018-2691-8

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