Calcium and Magnesium for Oxaliplatin-Induced Neurotoxicity: Issues in Study Design, Measurement, and Analysis

© 2015 Harborside Press® eurotoxicity associated with chemotherapy continues to be of great concern to both advanced practitioners in oncology and the patients they care for. Chemotherapy-induced peripheral neuropathy (CIPN) is considered the dose-limiting toxicity for oxaliplatin, an agent commonly used to treat colorectal cancer (Loprinzi et al., 2014). When administered, oxaliplatin accumulates in the dorsal root ganglia, resulting in axonal neuronopathy (Padman et al., 2014). The neurotoxicity associated with oxaliplatin can be acute or chronic (Tofthagen, McAllister, & McMillan, 2011; Beijers, Jongen, & Vreugdenhil, 2012). Acute neuropathy occurs in 85% to 95% of treated patients, and is manifested by sensitivity to cold, paresthesia, dysesthesia, and muscle contractions of the hands, feet, and circumoral region of the face, while chronic neurotoxicity has a gradual onset with mostly distal to proximal sensory neuropathic symptoms such as paresthesia, dysesthesia, alterations in gait and balance, and decreased vibratory sensation (Tofthagen, McAllister, & McMillan, 2011). Studies of treatments to prevent CIPN are challenging to conduct and occasionally result in conflicting results and clinical recommendations.