Abstract
Goal
The goal of this study was to investigate the potential role of clinical and electrophysiological signs of chemotherapy-induced neurotoxicity (CIPN) in predicting the final outcome of CIPN.
Patients and methods
We prospectively studied 46 cancer patients treated with paclitaxel, cisplatin, or their combination-containing regimens for a nonmyeloid malignancy. The clinical evaluation of neuropathy was based on the modified Neurological Symptom and Neurological Disability Scores. Neurophysiological examination was also carried out. The battery of clinical and electrophysiological tests was repeated at the third and sixth courses of chemotherapy and up to 3 months after its cessation. Results of the clinical and electrophysiological study were summarized by means of a modified peripheral neuropathy (PNP) score.
Results
Patients were divided according to the PNP scores obtained at follow-ups into those with better outcome (group 1, PNP <14, n=19) and those with worse outcome (group 2, PNP >15, n=27). In each patient and before the maximum severity of CIPN had been reached, the incidence of clinical and electrophysiological variables was determined and compared between groups. After univariate analysis two variables from the clinical evaluation and one from the neurophysiological evaluation were related to higher severity of CIPN and thus with worse outcome. Multivariate regression analysis defined only one of them, namely, the decrease sural a-SAP >50% of the baseline value, as being the sole, significant predictor of worse neurological outcome.
Conclusion
Our study indicates that a precise clinical evaluation combined with a detailed electrophysiological evaluation could predict the final neurological outcome of the cisplatin- or/and paclitaxel-based chemotherapy.
Similar content being viewed by others
References
Alberts DS, Noel JK (1995) Cisplatin-associated neurotoxicity: can it be prevented? Anti-cancer Drugs 6:369–383
Argyriou AA, Chroni E, Koutras A et al (2005) Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology 64(1):26–31
Berger T, Malayeri R, Doppelbauer G et al (1997) Neurological monitoring of neurotoxicity induced by paclitaxel/cisplatin chemotherapy. Eur J Cancer 33(9):1393–1399
Bolton CF, Gilbert JJ, Girvin JP et al (1979) Nerve and muscle biopsy. Electrophysiology and morphology in polyneuropathy. Neurology 29:354–362
Cavaletti G, Bogliun G, Marzorati L et al (2004) Early predictors of peripheral neurotoxicity in cisplatin and paclitaxel combination chemotherapy. Ann Oncol 15:1439–1442
Chaudhry V, Rowinsky EK, Sartorius SE et al (1994) Peripheral neuropathy from taxol and cisplatin combination chemotherapy: clinical and electrophysiological studies. Ann Neurol 35:304–311
Chaundhry V, Cornblath DR, Corse A et al (2002) Thalidomide-induced neuropathy. Neurology 59:1872–1875
Dyck PJ, Thomas PK (eds) (1993) Peripheral neuropathy, vol 2. (3rd edn.) WB Saunders, Philadelphia, PA, pp 1310–1317
Jann S, Bramerio MA, Beretta S et al (2003) Diagnostic value of sural nerve matrix metalloproteinase-9 in diabetic patients with CIDP. Neurology 61(11):1607–1610
Kimura J (2001) Electrodiagnosis in diseases of nerve and muscle, principles and practice (3rd edn.). Oxford University Press, New York, pp 91–166
Lauria G, McArthur JC, Hauer PE et al (1998) Neuropathological alterations in diabetic truncal neuropathy: evaluation by skin biopsy. J Neurol Neurosurg Psychiatry 65(5):762–766
Lauria G, Pareyson D, Grisoli M et al (2000) Clinical and magnetic resonance imaging findings in chronic sensory ganglionopathies. Ann Neurol 47(1):104–109
Lipton RB, Apfel SC, Dutcher JP et al (1989) Taxol produces a predominantly sensory neuropathy. Neurology 39:368–373
Malik RA, Veves A, Walker D et al (2001) Sural nerve fibre pathology in diabetic patients with mild neuropathy: relationship to pain, quantitative sensory testing and peripheral nerve electrophysiology. Acta Neuropathol 101(4):367–374
McCarthy BG, Hsieh ST, Stocks A et al (1995) Cutaneous innervation in sensory neuropathies: evaluation by skin biopsy. Neurology 45(10):1848–1855
Miller AB, Hoogstraten B, Staquet M, Winkler A (1981) Reporting results of cancer treatment. Cancer 47:207–214
Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655
Postma TJ, Heimans JJ (2000) Grading of chemotherapy-induced peripheral neuropathy. Ann Oncol 11:509–513
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Argyriou, A.A., Polychronopoulos, P., Koutras, A. et al. Peripheral neuropathy induced by administration of cisplatin- and paclitaxel-based chemotherapy. Could it be predicted?. Support Care Cancer 13, 647–651 (2005). https://doi.org/10.1007/s00520-005-0776-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-005-0776-9