© 2004 European Society for Medical Oncology
Original Article |
Early predictors of peripheral neurotoxicity in cisplatin and paclitaxel combination chemotherapy
1 Dipartimento di Neuroscienze e Tecnologie Biomediche and 4 Dipartimento di Scienze Chirurgiche, Università di Milano ‘Bicocca’, Monza; 2 Clinica Neurologica and 5 Clinica Ginecologica, A.O. S. Gerardo, Monza; 3 Dipartimento di Ginecologia Oncologica, Istituto Europeo di Oncologia, Milano; 6 Sigma-Tau ifr, Pomezia, Italy
* Correspondence to: Professor Guido Cavaletti, Clinica Neurologica, Ospedale S. Gerardo, V. Donizetti 106, 20052 Monza, Italy. Tel: +39-039-233-2379; Fax: +39-02-700-438-655; Email: guido.cavaletti{at}unimib.it
Background: We investigated the possible use of clinical signs of chemotherapy-induced peripheral neurotoxicity (CIPN) or of nerve growth factor (NGF) circulating levels to predict the final outcome of CIPN.
Patients and methods: Sixty-two women affected by locally advanced squamous cervical carcinoma treated with TP (paclitaxel 175 mg/m2 over a 3 h infusion plus cisplatin 75 mg/m2) or TIP (TP plus ifosphamide 5 mg/m2) were examined and scored according to the Total Neuropathy Score (TNS), before and during chemotherapy.
Results: A correlation with the final severity of CIPN was observed with vibration perception and deep tendon reflex evaluation, while pin sensibility, strength, and autonomic symptoms and signs were not informative. A highly significant correlation existed between the decrease in circulating levels of NGF and the severity of CIPN (r=–0.579; P <0.001; 95% confidence limits –0.702 to –0.423). However, circulating levels of NGF were not effective as predictors of the final neurological outcome of each patient.
Conclusion: Our study indicates that a precise clinical evaluation of the peripheral nervous system of patients treated with platinum and taxane combination polychemotherapy not only gives reliable information regarding the course of CIPN, but also can be used to predict the final neurological outcome of the treatment.
Key words: chemotherapy, cisplatin, neuropathy, paclitaxel
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