Incidence and risk factors associated with development of oxalipatin-induced acute peripheral neuropathy in colorectal cancer patients

Abstract

Introduction Oxaliplatin utilized in colorectal neoplasms treatment could induce acute peripheral neuropathy (APN) which is a dreadful and frequent adverse event. The objective of this study is to estimate incidence of APN induced by oxaliplatin cumulative incidence in cancer patients colorectal and to describe the distribution of the APN incidence according to demographic and clinical characteristics, as well as according to oxaliplatin cumulative dose. Material and methods This is a prospective descriptive study which took place from June to December 2018 at the Salah Azaiz Institute, Tunis. Demographic data, clinical data and data on oxaliplatin administration were collected from patient interview, medical files and pharmaceutical databases. Results The APN (grade 1, grade 2 and grade 3) cumulative incidence during the period of six months of follow up was 86% (95% CI [0.7815–0.9132]). While 38.3% (95% CI [0.29–0.48]) of the patients had grade 2 or 3 neuropathy. The search for factors associated with the risk of grade 2 and 3 NAP revealed trend significant association with diabetes (adjusted RR = 5.7 (IC95% [0.9- 37.3]; p = 0.07). Moreover, there was significant association with oxaliplatin cumulative dose (≥421 mg/m2) to increase the risk of APN grade 2 and 3 (adjusted RR = 7.8; [2.7–22.7]; p = 0.0001). Furthermore, significant association with obesity to increase the risk of APN grade 2 and 3 (adjusted RR = 5.3 [1.1- 25.4]; p = 0.04) was found. Among the patients included, 31.1% experienced oxaliplatin dose reduction and in the majority of cases this reduction is due to neurotoxicity (90.9%). Conclusion The high incidence of oxaliplatin-induced APN remains an embarrassing and handicapping side effect. Our study has shown that oxaliplatin cumulative dose (≥421 mg/m2), diabetes and obesity are risk factor for the development of grade 2 and 3 APN.

Potential Mediators of Oxaliplatin-Induced Peripheral Neuropathy From Adjuvant Therapy in Stage III Colon Cancer: Findings From CALGB (Alliance)/SWOG 80702

“…Although several studies have previously examined the relationship between BMI and OIPN in CRC, they have reported conflicting findings. One retrospective investigation 6 observed an inverse relationship between BMI and OIPN; however, four prospective studies [7][8][9][10] of approximately 100 patients with CRC each reported a positive correlation. In our significantly larger cohort, we similarly demonstrate that a higher BMI is associated with increased severity of CTCAEreported-although not FACT/GOG-NTX-13-measuredneuropathy.…”

“…Conflicting findings have been reported regarding the clinical and sociodemographic factors predisposing patients with colorectal cancer (CRC) to oxaliplatininduced peripheral neuropathy (OIPN). 1,2 Only receipt of a higher cumulative dose has consistently been associated with greater neurotoxicity, 2-5 whereas discordant findings have been reported regarding the contributions of body mass index (BMI) [6][7][8][9][10] and diabetes mellitus. [10][11][12][13][14] Nonsteroidal anti-inflammatory drug (NSAID) use, 15 physical activity, 16 and vitamin B6 17 have additionally been posited to influence OIPN in CRC, but little evidence currently exists to substantiate these hypotheses.…”

Short-Term Safety Evaluation of Albumin-Bound Paclitaxel in Intraoperative and Postoperative Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer

“…Additionally, other chemotherapeutic agents such as mitomycin C and irinotecan also have myelosuppressive side effects, which may lead to a reduction in neutrophils in patients after surgery [41,42]. Oxaliplatin may not only cause hemorrhagic complications [43] but also poses an increased risk of neurotoxicity for diabetic patients [44]. Moreover, many chemotherapeutic agents, such as capecitabine [45] and apatinib [46], can also cause common gastrointestinal reactions like nausea, vomiting, and diarrhea.…”

The association of clinical and patient factors with chemotherapy-induced peripheral neuropathy (CIPN) in colorectal cancer: secondary analysis of the SCOT trial

“…Factors that predispose CIPN, that have been reported previously, include age >65 years, 16 low haemoglobin levels, 17 higher body mass index (BMI), 18 , 19 diabetes, 20 , 21 and history of neuropathy. 22 However, studies of patient-related CIPN risk factors often show conflicting results.…”