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The Kampo medicine, Goshajinkigan, prevents neuropathy in patients treated by FOLFOX regimen

International Journal of Clinical Oncology volume 16, pages 322–327 (2011)Cite this article

Abstract

Background

Oxaliplatin is now considered a standard treatment for advanced or unresectable colorectal cancer, but its main dose-limiting toxicity is sensory neuropathy. The OPTIMOX (stop and go) approach offers a reasonable strategy, but the preventive agent is not established. It is reported that the Kampo medicine, Goshajinkigan (GJG), has recently been considered an effective agent for the neuropathy of taxanes and for vibration sensation in patients with diabetic neuropathy. The aim of this study was to clarify the efficacy of GJG for peripheral neuropathy associated with oxaliplatin therapy.

Patients and method

From 2007, 45 patients treated with modified FOLFOX6 for non-resectable or recurrent colorectal cancer participated in the study. Twenty-two patients (GJG group) received oral administration of 7.5 g/day of GJG every day during mFOLFOX6 therapy and 23 patients (control group) did not receive GJG. Neuropathy was evaluated during every course according to DEB-NTC (Neurotoxicity Criteria of Debiopharm).

Results

The median number of cycles per patient in the GJG group was 13 (range 4–32), and in the control group was 12 (range 4–28). The cumulative dose of oxaliplatin was 1105 mg/m2 (GJG group) and 1120 mg/m2 (control group). The incidence of grade 3 peripheral neuropathy in the GJG group was significantly lower than in the control group (p < 0.01, log-rank test). The incidence of grade 3 peripheral neuropathy after 10 courses was 0% in the GJG group and 12% in the control group, and after 20 courses was 33% in the GJG group and 75% in the control group. The percentage of grade 2 and 3 peripheral neuropathy in the GJG group was lower than that in the control group. There were no differences in adverse effects between the two groups except for peripheral neuropathy and influence on tumor response.

Conclusion

The Kampo medicine, Goshajinkigan, is useful in preventing neuropathy in non-resectable or recurrent colorectal cancer patients treated with a FOLFOX regimen.

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Acknowledgments

This study was partly supported by the Research Support Foundation of The University of Tokushima and TAIHO Pharmaceutical co., LTD., and the Grants-in-Aid for Scientific Research of the Japan Society for the Promotion of Science. A part of this study was presented at the Gastrointestinal Cancer Symposium, Orlando, FL, USA (January 22–24, 2010).

Conflict of interest

No author has any conflict of interest.

Author information

Affiliations

  1. Department of Surgery, Institute of Health Biosciences, The University of Tokushima, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan

    Masanori Nishioka, Mitsuo Shimada, Nobuhiro Kurita, Takashi Iwata, Shinya Morimoto, Kozo Yoshikawa, Jun Higashijima & Tomohiko Miyatani

  2. Department of Surgery, Division of Gastroenterologic and General Surgery, Asahikawa Medical College, 2-1 Midorigaoka-higashi, Asahikawa, Hokkaido, 078-8510, Japan

    Toru Kono

Authors
  1. Masanori Nishioka
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  2. Mitsuo Shimada
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  3. Nobuhiro Kurita
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  4. Takashi Iwata
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  5. Shinya Morimoto
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  6. Kozo Yoshikawa
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  7. Jun Higashijima
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  8. Tomohiko Miyatani
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  9. Toru Kono
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Correspondence to Masanori Nishioka.

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Nishioka, M., Shimada, M., Kurita, N. et al. The Kampo medicine, Goshajinkigan, prevents neuropathy in patients treated by FOLFOX regimen. Int J Clin Oncol 16, 322–327 (2011). https://doi.org/10.1007/s10147-010-0183-1

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  • DOI: https://doi.org/10.1007/s10147-010-0183-1

Keywords

  • Neuropathy
  • Kampo medicine
  • Goshajinkigan
  • Oxaliplatin
  • Colorectal cancer