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Incidence of atypical acute nerve hyperexcitability symptoms in oxaliplatin-treated patients with colorectal cancer

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Abstract

Context

Peripheral, acute or chronic, neurotoxicity is one of the main dose-limiting adverse effects of oxaliplatin (OXA). Acute neurotoxicity is typically characterized by distal and perioral cold-induced paresthesias and dysesthesias, but other uncommon symptoms might also be present.

Objectives

The aim of this post hoc analysis of data extracted from a prospective, multicenter study was to assess the incidence of uncommon acute OXA neurotoxicity symptoms in patients undergoing OXA-based chemotherapy.

Methods

One hundred chemotherapy-naïve patients (62 males, 38 females, aged 64.7 ± 8.7 years) with colorectal cancer scheduled to receive OXA-based therapy (FOLFOX-4, FOLFOX-6, and XELOX) underwent neurologic evaluation after the 1st infusion and then after 3 and 6 months of OXA-based chemotherapy (after 6th or 4th and 12th or 8th cycles, respectively, according to regimen). At evaluation, patients were asked to report the presence and characteristics of acute hyperexcitability symptoms.

Results

Eighty-two patients presented typical symptoms of acute OXA neurotoxicity in the form of cold-induced paresthesias and dysesthesias. In 45/82 (54.9 %) of patients, uncommon symptoms were also present; shortness of breath (32 %), jaw spasm (26 %), fasciculations (25 %), cramps (20 %), and difficulty in swallowing (18 %) were more frequently reported, while voice (4 %) and visual changes, ptosis and pseudolaryngospasm (1 %) occurred rarely. No significant correlation was disclosed between acute OXA neurotoxicity and chemotherapy regimen, cumulative dose of OXA or patients’ age.

Conclusions

A high percentage of patients treated with OXA-based chemotherapy develop acute neurotoxicity also with uncommon manifestations. Since OXA acute neurotoxicity might be related to the onset of chronic neurotoxicity, these patients should be closely monitored to avoid this dose-limiting adverse effect.

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References

  1. Argyriou AA, Polychronopoulos P, Iconomou G et al (2008) A review on oxaliplatin-induced peripheral nerve damage. Cancer Treat Rev 34(4):368–377

    Article  PubMed  CAS  Google Scholar 

  2. Argyriou AA, Bruna J, Marmiroli P, Cavaletti G (2012) Chemotherapy-induced peripheral neurotoxicity (CIPN): an update. Crit Rev Oncol Hematol 82(1):51–77

    Article  PubMed  Google Scholar 

  3. Park SB, Lin CS, Krishnan AV et al (2011) Utilizing natural activity to dissect the pathophysiology of acute oxaliplatin-induced neuropathy. Exp Neurol 227(1):120–127

    Article  PubMed  CAS  Google Scholar 

  4. Santini D, Vincenzi B, La Cesa A et al (2003) Recurrent episodes of involuntary masticatory spasms induced by continuous infusion of oxaliplatin. J Natl Cancer Inst 95(20):1555–1556

    Article  PubMed  Google Scholar 

  5. Park SB, Goldstein D, Lin CS et al (2009) Acute abnormalities of sensory nerve function associated with oxaliplatin-induced neurotoxicity. J Clin Oncol 27(8):1243–1249

    Article  PubMed  CAS  Google Scholar 

  6. Park SB, Lin CS, Krishnan AV et al (2009) Oxaliplatin-induced neurotoxicity: changes in axonal excitability precede development of neuropathy. Brain 132(10):2712–2723

    Article  PubMed  Google Scholar 

  7. Bongenhielm U, Nosrat CA, Nosrat I et al (2000) Expression of sodium channel SNS/PN3 and ankyrin(G) mRNAs in the trigeminal ganglion after inferior alveolar nerve injury in the rat. Exp Neurol 164(2):384–395

    Article  PubMed  CAS  Google Scholar 

  8. Grolleau F, Gamelin L, Boisdron-Celle M et al (2001) A possible explanation for a neurotoxic effect of the anticancer agent oxaliplatin on neuronal voltage-gated sodium channels. J Neurophysiol 85(5):2293–2297

    PubMed  CAS  Google Scholar 

  9. Petrioli R, Pascucci A, Francini E et al (2008) Neurotoxicity of FOLFOX-4 as adjuvant treatment for patients with colon and gastric cancer: a randomized study of two different schedules of oxaliplatin. Cancer Chemother Pharmacol 61(1):105–111

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors thank Dr. Mario Ermani for statistical analysis. The Spanish participation has been supported by Grant PI070493 from Instituto de Salud Carlos III’ (ISCIII’). Otherwise, no funding source had a role in the preparation of this paper or in the decision to submit it for publication.

Conflict of interest

The authors have declared no conflicts of interest.

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Authors and Affiliations

  1. Department of Neurosciences, University of Padova, Padua, Italy

    Marta Lucchetta & Chiara Briani

  2. Oncology Unit 1, Veneto oncology Institute—IRCCS, Padua, Italy

    Sara Lonardi & Francesca Bergamo

  3. Department of Neuroscience and Biomedical Technology, University of Milan-Bicocca, Monza, Italy

    Paola Alberti & Guido Cavaletti

  4. Unit of Neuro-Oncology, Bellvitge University Hospital, Barcelona, Spain

    Roser Velasco & Jordi Bruna

  5. Division of Clinical Oncology, Department of Medicine, University Hospital, University of Patras Medical School, 26504, Rion-Patras, Greece

    Andreas A. Argyriou & Haralabos P. Kalofonos

  6. Department of Oncology, S. Gerardo Hospital, Monza, Italy

    Marina Cazzaniga & Diego Cortinovis

Authors
  1. Marta Lucchetta
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  2. Sara Lonardi
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  3. Francesca Bergamo
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  4. Paola Alberti
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  5. Roser Velasco
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  6. Andreas A. Argyriou
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  7. Chiara Briani
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  8. Jordi Bruna
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  9. Marina Cazzaniga
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  10. Diego Cortinovis
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  11. Guido Cavaletti
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  12. Haralabos P. Kalofonos
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Corresponding author

Correspondence to Haralabos P. Kalofonos.

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Lucchetta, M., Lonardi, S., Bergamo, F. et al. Incidence of atypical acute nerve hyperexcitability symptoms in oxaliplatin-treated patients with colorectal cancer. Cancer Chemother Pharmacol 70, 899–902 (2012). https://doi.org/10.1007/s00280-012-2006-8

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  • DOI: https://doi.org/10.1007/s00280-012-2006-8

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