Peripheral neuropathy secondary to oxaliplatin in patients treated for colorectal carcinoma

Abstract

Introduction: Peripheral neuropathy secondary to oxaliplatin is very frequent it is defined by damage of the peripheral nervous systemgenerated by oxaliplatin, due to the fragility of the blood-brain barrier in the peripheral nerve. These neuropathies are characterized by the symmetry of the neurological disorders and their distal predominance without any truncated or radicular systematization. In most patients, this neuropathy is only partially reversible and can persist long after the stop of chemotherapy. This is one of the major dose-limiting side effects of chemotherapy that may lead not only to the loss of function physical activity associated with a decrease in the quality of life and difficulties in daily activities, especially if it is an elderly person but which can also result in the reduction and/or delay of the administration dose or even in the worst Of the cases the stop of the treatment. Methods: This is a prospective descriptive and analytical study including patients with colorectal carcinoma treated with oxaliplatin-based chemotherapy whose main objective is to determine the frequency of neurotoxicity, its characteristics and its impact on quality of life. Results: We collected 21 patients. 57% were female. The mean age was 50.5 years [28-69]. 10% of patients had a history of diabetes. The majority of patients (85%) were treated for localised colorectal carcinoma. A total of 137 oxaliplatin-based cures (80% XELOX) at the total dose or 130 mg/m2 (60%) were administered with an average of 5 cures per patient [5,8]. Peripheral neuropathy was reported in (109/137) cycles, after the 1st cure (57%) after the 2nd and 3rd cures (19% each). Peripheral neuropathy occurs on the first day after the cycle (48/109 cycles), with swarming (92/109) grade I (72/109), spontaneous (80/109) located at the hands, feet and the perioral region (82/109), symmetrical (109/109) with persistence of the symptomatology at least one week (61/109). Clinical examination revealed motor function and osteo-tendinous reflexes conserved . Our conduct was to prolong the duration of the oxaliplatin infusion at 4 hours in 28% of cases, a deferral of cure on average of (12/ 109) due to a contraindication, a vitamin supplement medication in 47% and pregabalin in 8% of cases and a definite cessation of treatment in a patient. Despite all its measures, 9% of patients had an impact on the quality of life, namely a limitation of daily activities. Peripheral neuropathy persisted even after the end of treatment. Conclusion: Peripheral neuropathy induced by the oxaliplatin is the limiting factor in treatment in patients with colorectal carcinoma . Its severity in its character persistent and evolutionary even after the stop of the treatment,Its early detection is capital and can modify the subsequent therapeutic management in order to limit or to regress the induced disorders.