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.

Lucchetta, M., Lonardi, S., Bergamo, F., Alberti, P., Velasco, R., Argyriou, A., et al. (2012). Incidence of atypical acute nerve hyperexcitability symptoms in oxaliplatin-treated patients with colorectal cancer. CANCER CHEMOTHERAPY AND PHARMACOLOGY, 70(6), 899-902 [10.1007/s00280-012-2006-8].

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

ALBERTI, PAOLA;Cazzaniga, M;CAVALETTI, GUIDO ANGELO;
2012

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.
Si
Articolo in rivista - Articolo scientifico
Scientifica
Spasm; Acute Disease; Drug Administration Schedule; Neurotoxicity Syndromes; Antineoplastic Agents; Humans; Leucovorin; Aged; Deglutition Disorders; Prospective Studies; Deoxycytidine; Paresthesia; Fluorouracil; Antineoplastic Combined Chemotherapy Protocols; Organoplatinum Compounds; Incidence; Middle Aged; Dyspnea; Male; Colorectal Neoplasms; Female
English
899
902
4
Lucchetta, M., Lonardi, S., Bergamo, F., Alberti, P., Velasco, R., Argyriou, A., et al. (2012). Incidence of atypical acute nerve hyperexcitability symptoms in oxaliplatin-treated patients with colorectal cancer. CANCER CHEMOTHERAPY AND PHARMACOLOGY, 70(6), 899-902 [10.1007/s00280-012-2006-8].
Lucchetta, M; Lonardi, S; Bergamo, F; Alberti, P; Velasco, R; Argyriou, A; Briani, C; Bruna, J; Cazzaniga, M; Cortinovis, D; Cavaletti, G; Kalofonos, H
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/44806
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