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Prospective Study of the Clinical, Electrophysiologic, and Sonographic Characteristics of Oxaliplatin‐Induced Neuropathy
Author(s) -
Pitarokoili Kalliopi,
Höffken Nadine,
Lönneker Niko,
Fisse Anna Lena,
Trampe Nadine,
Gold Ralf,
ReinacherSchick Anke,
Yoon MinSuk
Publication year - 2018
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12557
Subject(s) - medicine , oxaliplatin , electrophysiology , folfirinox , chemotherapy , pancreatic cancer , peripheral neuropathy , surgery , cancer , colorectal cancer , endocrinology , diabetes mellitus
BACKGROUND AND PURPOSE Oxaliplatin‐induced neuropathy is a major dose limiting side effect of the highly effective combination chemotherapy with oxaliplatin, irinotecan, and 5‐fluorouracil (FOLFIRINOX) in patients with metastastic pancreatic cancer. We present the first longitudinal sonographical‐electrophysiological study on oxaliplatin‐induced neuropathy. METHODS Thirteen patients with metastatic pancreatic cancer underwent clinical, sonographic, and electrophysiological evaluation before, 3 and 7 months after treatment with 12 two‐week cycles of FOLFIRINOX. RESULTS The majority of patients (61%) developed symptoms and electrophysiological signs of a length‐dependent sensorimotor axonal neuropathy 7 months after treatment initiation. Oxaliplatin‐induced neuropathy presented with a cross‐sectional area (CSA) increase of mostly the tibial and fibular nerve, which developed parallel or prior to clinical signs and electrophysiological changes. Furthermore, isolated CSA at entrapment sites of the upper and lower extremities was measured without relevant symptoms. No correlation between sonographic and electrophysiological findings or clinical severity was detected. CONCLUSIONS Oxaliplatin‐induced neuropathy is characterized by an axonal length‐dependent nerve affection presenting with a combination of sonographical and electrophysiological alterations.