Supportive Care in Cancer

, Volume 14, Issue 5, pp 484–487

N-acetylcysteine has neuroprotective effects against oxaliplatin-based adjuvant chemotherapy in colon cancer patients: preliminary data

  • Peng-Chan Lin
  • Ming-Yang Lee
  • Wei-Shu Wang
  • Chueh-Chuan Yen
  • Ta-Chung Chao
  • Liang-Tsai Hsiao
  • Muh-Hwa Yang
  • Po-Min Chen
  • Kon-Ping Lin
  • Tzeon-Jye Chiou
Short Communication

DOI: 10.1007/s00520-006-0018-9

Cite this article as:
Lin, PC., Lee, MY., Wang, WS. et al. Support Care Cancer (2006) 14: 484. doi:10.1007/s00520-006-0018-9

Abstract

Although adding oxaliplatin to fluorouracil and leucovorin in adjuvant chemotherapy for colon cancer may improve disease-free survival, grade 3–4 sensory neuropathy also increases. To determine whether oral N-acetylcysteine is neuroprotective against oxaliplatin-induced neuropathy, we did a pilot study. Fourteen stage III colon cancer patients with 4 or more regional lymph nodes metastasis (N2 disease) receiving adjuvant biweekly oxaliplatin (85 mg/m2) plus weekly fluorouracil boluses and low-dose leucovorin were randomized to oral N-acetylcysteine (1,200 mg) (arm A) or placebo (arm B). Clinical neurological and electrophysiological evaluations were performed at baseline and after 4, 8, and 12 treatment cycles. Treatment-related toxicity was evaluated based on National Cancer Institute (NCI) Criteria. After four cycles of chemotherapy, seven of nine patients in arm B and two of five in arm A experienced grade 1 sensory neuropathy. After eight cycles, five experienced sensory neuropathy (grade 2–4 toxicity) in arm B; none in arm A (p<0.05). After 12 cycles, grade 2–4 sensory neuropathy was observed in eight patients in arm B, one in arm A (p<0.05). There were no significant electrophysiological changes in arm A after 4, 8, or 12 cycles of chemotherapy. We concluded that oral N-acetylcysteine reduces the incidence of oxaliplatin-induced neuropathy in colon cancer patients receiving oxaliplatin-based adjuvant chemotherapy.

Keywords

N-AcetylcysteineOxaliplatin-based adjuvant chemotherapyColon cancer

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Peng-Chan Lin
    • 1
  • Ming-Yang Lee
    • 1
  • Wei-Shu Wang
    • 1
  • Chueh-Chuan Yen
    • 1
  • Ta-Chung Chao
    • 1
  • Liang-Tsai Hsiao
    • 1
  • Muh-Hwa Yang
    • 1
  • Po-Min Chen
    • 1
  • Kon-Ping Lin
    • 2
  • Tzeon-Jye Chiou
    • 1
  1. 1.Division of Medical Oncology, Department of MedicineTaipei Veterans General Hospital and National Yang-Ming University School of MedicineTaipeiRepublic of China
  2. 2.Division of NeurologyInstitute of Neurological Taipei Science Veterans General HospitalTaipeiRepublic of China