Oxaliplatin-induced peripheral neuropathy risk factors and management in Tunisian population

Abstract

The most important limits of oxaliplatin treatment is its peripheral neurotoxicity. The aim of our study was to evaluate the oxaliplatin-induced peripheral neuropathy, its impact on treatment and its management. One hundred chemo-naive patients treated with oxaliplatin-based regimen in the medical oncology department of the military hospital of Tunis between 2012 and 2017 were recruited retrospectively. Evaluation of neuropathy was done according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE V4). Fifty six patients were aged more than 60 years. The sex-ratio was 1.56. Twenty seven patients were overweight, 17 were obese and 56 had a BMI inferior to 25 kg/m2. Two patients were consuming alcohol. Twenty three patients had diabetes. Sixty four patients developed chronic peripheral neuropathy because of oxaliplatin (grade 1-2 in 58 cases and grade 3 in 6 cases). Sex, BMI, diabetes and alcohol consumption were not associated with the development of peripheral neuropathy. No association was found between grades of neuropathy and sex, alcohol consumption and diabetes. The median cumulative dose of oxaliplatin that induced neuropathy was 432.4 mg/m2. The most prescribed treatment was Gabapentin (81%) and carbamazepine (16.8%). The treatment was not sufficient to stop neuropathy in 82.6% of cases. Dose reduction was done in 64.2% of cases, treatment delay in 10.7% of cases and treatment interruption in 10.7% of cases. We didn´t found any association between known risk factors and peripheral neuropathy. The cumulative dose is interesting to define to predict the timing of neurotoxicity.

Keywords

• chemotherapy
• toxicity
• oxaliplatin
• neuropathy