Impact of oxaliplatin-induced neuropathy: a patient perspective.

Dose-limiting neurotoxicity is a major side effect of oxaliplatin treatment, producing initial acute neurotoxicity and chronic neuropathy with increasing exposure. The improvement in survival for patients with early-stage colorectal cancer treated with oxaliplatin has highlighted the need for valid and reliable assessment of peripheral neuropathy.
The objective of this paper was to explore neuropathic symptoms in oxaliplatin-treated patients as assessed using different methods.
Consecutive symptomatic patients reporting peripheral neuropathy after oxaliplatin chemotherapy for colorectal cancer were interviewed using a semi-structured clinical interview. Neurotoxicity was also assessed using the National Cancer Institute Common Toxicity Criteria scale (clinician-rated), patient 'self-report' questionnaires (PNQ), nerve conduction and clinical assessment.
Twenty patients were assessed, 12.6 ± 2.8 months after treatment cessation (mean cumulative oxaliplatin dose, 789 mg/m(2)). In 40% of patients, neurotoxicity necessitated early cessation of treatment. Only 10% of patients were designated by clinicians with severe neurotoxicity, whilst, in contrast, patient interviews and self-report questionnaires described significant physical limitations due to neuropathic symptoms in 60% of patients. The majority (85%) of patients had objective evidence of sensory neuropathy with nerve conduction studies. Reports from clinical interviews were strongly correlated with patient self-assessment (Pearson coefficient = 0.790, p < 0.0005).
Given the discrepancies in symptom prevalence highlighted by these findings, the monitoring of oxaliplatin-induced neurotoxicity would benefit from more informative clinical assessment, with inclusion of patient-reported outcome measures. Such an approach would be beneficial in a clinical trial setting to monitor the efficacy of interventions and in prospective studies of survivorship to determine the true burden of peripheral neuropathy in oxaliplatin-treated patients.
AuthorsBarbara K Bennett, Susanna B Park, Cindy S-Y Lin, Michael L Friedlander, Matthew C Kiernan, David Goldstein
JournalSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Support Care Cancer) Vol. 20 Issue 11 Pg. 2959-67 (Nov 2012) ISSN: 1433-7339 [Electronic] Germany
PMID22426503 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Validation Studies)
Chemical References
  • Antineoplastic Agents
  • Organoplatinum Compounds
  • oxaliplatin
  • Adult
  • Aged
  • Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
  • Colorectal Neoplasms (drug therapy)
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neurotoxicity Syndromes (diagnosis, etiology, physiopathology)
  • Organoplatinum Compounds (administration & dosage, adverse effects, therapeutic use)
  • Outcome Assessment (Health Care)
  • Severity of Illness Index
  • Surveys and Questionnaires

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