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Visual evoked potentials findings in course of paclitaxel doxorubicin combination chemotherapy

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Abstract

The case of a 63 year-old woman affected by advanced breast cancer is reported. Chemotherapy with paclitaxel (200 mg/m2) and doxorubicin (60 mg/m2) every three weeks was given for 8 cycles. The patient progressively developed a sensory-motor neuropathy of axonal type. After the 6th chemotherapy cycle the patient complained of subjective visual symptoms without a relevant reduction of visual acuity. Visual evoked potentials (VEPs) showed an important reduction of the amplitude of the P100 component with a less pronounced delay in latency. Electroretinic responses were normal. These findings suggest an optic neuropathy, confirming previous reports of the occurrence of optic nerve involvement in course of paclitaxel chemotherapy. The role of VEP assessment in course of paclitaxel chemotherapy is discussed comparing clinical and neurophysiological findings in this case with three previously reported cases.

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References

  1. Gianni L, Capri G, Munzone E, Straneo E: Paclitaxel (Taxol) efficacy in patients with advanced breast cancer resistant to anthracyclines. Sem Oncol 5 (Suppl 8): 29–33, 1994

    Google Scholar 

  2. Murphy WK, Fossella FV, Winn RJ, et al.: Phase II study of Taxol in patients with untreated advanced non-small cell lung cancer. J Natl Cancer Inst 85: 384–388, 1993

    Google Scholar 

  3. Runowicz CD, Wiernick PH, Einzig AI, Goldberg GL, Horwitz SB: Taxol in ovarian cancer. Cancer 71: 1591–1596, 1993

    Google Scholar 

  4. Rowinsky EK, Eisenhauer EA, Chaudhry V, Arbuck SG, Donehower RC: Clinical toxicities encountered with paclitaxel (Taxol ®). Sem Oncol 20 (Suppl 3): 1–15, 1993

    Google Scholar 

  5. Rowinsky EK, Chaudhry V, Cornblath DR, Donehover RC: Neurotoxicity of Taxol. Monogr Natl Cancer Inst 15: 107–115, 1993

    Google Scholar 

  6. Lipton RB, Apfel SC, Dutcher JP, Rosenberg R, Kaplan J, Berger A, Einzig AI, Wiernick P, Schaumburg HH: Taxol produces a predominantly sensory neuropathy. Neurology 39: 368–373, 1989

    Google Scholar 

  7. Chaudhry V, Rowinsky EK, Sartorius SE, Donehower RC, Cornblath DR: Peripheral neuropathy from taxol and cisplatin combination chemotherapy. Clinical and electrophysiological studies. Ann Neurol 35: 304–311, 1994

    Google Scholar 

  8. Kaplan JG, Einzig AI, Schaumburg HH: Taxol causes permanent large fiber peripheral nerve dysfunction: a lesson for preventive strategies. J Neuro-oncol 16: 105–107, 1993

    Google Scholar 

  9. Capri G, Munzone E, Tarenzi E, Fulfaro F, Caraceni A, Martini C, Scaioli V: Optic nerve disturbances: a new form of paclitaxel neurotoxicity. J Natl Cancer Inst 86: 1099–1101, 1994

    Google Scholar 

  10. Seidman AD, Barrett S, Canezo S: Photopsia during 3-hour paclitaxel administration at doses ≥ 250 mg/mq. J Clin Oncol 12: 1741–1742, 1994

    Google Scholar 

  11. Goldberg JM, Lindblom U: Standardised method of determining vibratory perception thresholds for diagnosis and screening in neurological investigation. J Neurol Neurosurg Psychiatry 42: 793–803, 1979

    Google Scholar 

  12. Green S, Weiss GR: Southwest oncology group standard response criteria, endpoint definitions and toxicity criteria. Invest New Drug 10: 239–253, 1992

    Google Scholar 

  13. Papakostopoulos D: Clinical electrophysiology of the human visual system. In: Chiarenza GA, Papakostopoulos D (eds) Clinical application of cerebral evoked potentials in pediatric medicine, Excerta Medica, Amsterdam, 1982, pp 3–40

    Google Scholar 

  14. Siegel IM, Kuppersmith MJ: Electrophysiological evaluation of visual loss in ophtalmology. In: Cracco RQ, Bodis-Wollner I (eds) Evoked potential, Alan R. Liss, New York, 1986, pp 333–342

    Google Scholar 

  15. Sherman J: Supplemental aids in the differential diagnosis of retinal versus optic nerve disease. In: Cracco RQ, Bodis-Wollner I (eds) Evoked potentials, Alan R. Liss, New York, 1986, pp 343–353

    Google Scholar 

  16. Windebank AJ, Blexrud MD, de Groen PC: Potential neurotoxicity of the solvent vehicle for cyclosporine. J Pharmacol Exp Ther 268: 1051–1056, 1994

    Google Scholar 

  17. Lodge NJ: Direct vasoconstrictor effects of sandimmune (cyclosporine A) are by its vehicle cremophor EL: inhibition by the thomboxane A2/prostaglandin enoperoxide receptor antagonist ifetroban. J Pharmacol Exp Ther 271: 730–734, 1994

    Google Scholar 

  18. Rischin D, Matthews JP, Webster LK, Milward MJ, Linahan BM, Toner GC, Woollett A, Murphy MJ, Bishop JF: 3 versus 6 versus 24 hour infusions of paclitaxel: a randomized, crossover comparison of toxicity, plasma cremophor levels and paclitaxel pharmacokinetics. Proc Am Soc Oncol 14: 464, 1995

    Google Scholar 

  19. Eisenhauer EA, ten Bokkel Huinink WW, Swenerton KD, Gianni L, Myles J: European-Canadian randomized trial of paclitaxel in relapsed ovarian cancer: high-dose versus lowdose and long versus short infusion. J Clin Oncol 12: 2654–2666, 1994

    Google Scholar 

  20. Curran CF, Luce JK: Ocular adverse reactions associated with adriamycin (doxorubicin). Am J Ophthalmol 108: 709–711, 1989

    Google Scholar 

  21. Gianni L, Locatelli L, Vigano'L, Capri G, Munzone E, Tarenzi E, Fulfaro F, Bonadonna G: Order of administration and pharmacokinetics of paclitaxel (P) by three hour infusion and doxorubicin (D). Proc Am Soc Clin Oncol 14: 169, 1995

    Google Scholar 

  22. Pavlidis NA, Petris C, Briassoulis E, Klouvas G, Psilas C, Rempapis J, Petroutsos G: Clear evidence that long-term, low-dose Tamoxifen treatment can induce ocular toxicity. A prospective study of 63 patients. Cancer 69: 2961–2964, 1992

    Google Scholar 

  23. Pugersgaard T, Edler Von Eyben F: Bilateral optic neuritis evolved during Tamoxifen treatment. Cancer 58: 383–386, 1986

    Google Scholar 

  24. Grant WM: Toxicology of the eye, 2nd ed. Springfield: Charles C. Thomas, 1974

  25. Kumar A, Sandramouli S, Verma L, Tewari HK, Khosla PK: Ocular ethambutol toxicity: is it reversible? J Clin Neuroophthal 13: 15–17, 1993

    Google Scholar 

  26. Ostrow S, Hahn D, Wiernik PH, Richards RD: Ophthalmic toxicity after cis-Dichlorodiammineplatinum (II) therapy. Cancer Treat Rep 62: 1591–1594, 1978

    Google Scholar 

  27. Walsh TJ, Clark W, Parhad IM, Green WR: Neurotoxic effects of cisplatin therapy. Arch Neurol 39: 719–720, 1982

    Google Scholar 

  28. Wilding G, Caruso R, Lawrence TS, Ostchega Y, Ballintine EJ, Young RC, Ozols RF: Retinal toxicity after high-dose cisplatin therapy. J Clin Oncol 3: 1683–1689, 1985

    Google Scholar 

  29. Maiese K, Walker RW, Gargan R, Victor JD: Intra-arterial cisplatin-associated optic and otic toxicity. Arch Neurol 49: 83–86, 1992

    Google Scholar 

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Scaioli, V., Caraceni, A., Martini, C. et al. Visual evoked potentials findings in course of paclitaxel doxorubicin combination chemotherapy. J Neuro-Oncol 25, 221–225 (1995). https://doi.org/10.1007/BF01053155

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