Hyperacute peripheral neuropathy is a predictor of oxaliplatin-induced persistent peripheral neuropathy.
PURPOSE
Chronic peripheral neuropathy is a major adverse response to oxaliplatin-containing chemotherapy regimens, but there are no established risk factors pertaining to it. We investigated the efficacy of hyperacute peripheral neuropathy (HAPN) as a predictor of oxaliplatin-induced persistent peripheral neuropathy (PPN).


METHODS
Forty-seven cases of stage III colorectal cancer who received adjuvant chemotherapy with oxaliplatin after curative surgery between January 2010 and August 2014 were retrospectively reviewed. HAPN was defined as acute peripheral neuropathy (APN) occurring on day 1 (≤24 h after oxaliplatin infusion) of the first cycle. PPN was defined as neuropathy lasting >1 year after oxaliplatin discontinuation.


RESULTS
The average total dose of oxaliplatin was 625.8 mg/m2, and the average relative dose intensity was 66.7%. Twenty-two of the 47 patients (46.8%) had PPN and 13 (27.7%) had HAPN. Male sex, treatment for neuropathy, HAPN, and APN were significantly more frequent in patients with PPN (p = 0.013, 0.02, <0.001, and 0.023, respectively). There was no significant difference in the total oxaliplatin dose between patients with and without PPN (p = 0.061). Multivariate analyses revealed total dose of oxaliplatin and HAPN as independent predictors of PPN [p = 0.015; odds ratio (OR) = 1.005, 95% confidence interval (CI), 1.001-1.009 and p = 0.001; OR = 75.307, 5.3-1070.123, respectively]. The total dose of oxaliplatin was relatively lower in patients with HAPN than that in those without HAPN in the PPN-positive group (not significant, p = 0.068).


CONCLUSION
HAPN was found to be a predictor of oxaliplatin-induced PPN.
['Tanishima|Hiroyuki|H|', 'Tominaga|Toshiji|T|', 'Kimura|Masamichi|M|', 'Maeda|Tsunehiro|T|', 'Shirai|Yasutsugu|Y|', 'Horiuchi|Tetsuya|T|']
D000328:Adult D000368:Aged D000971:Antineoplastic Combined Chemotherapy Protocols D017024:Chemotherapy, Adjuvant D002908:Chronic Disease D015179:Colorectal Neoplasms D005260:Female D005472:Fluorouracil D006801:Humans D002955:Leucovorin D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D009944:Organoplatinum Compounds D000077150:Oxaliplatin D010523:Peripheral Nervous System Diseases D011237:Predictive Value of Tests D012189:Retrospective Studies D012307:Risk Factors
Peripheral neuropathy Oxaliplatin Acute neuropathy Predictor of persistent peripheral neuropathy