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Long‐term course of oxaliplatin‐induced polyneuropathy: a prospective 2‐year follow‐up study
Authors:Chiara Briani  Andreas A Argyriou  Cristina Izquierdo  Roser Velasco  Marta Campagnolo  Paola Alberti  Barbara Frigeni  Mario Cacciavillani  Francesca Bergamo  Diego Cortinovis  Marina Cazzaniga  Jordi Bruna  Guido Cavaletti  Haralabos P Kalofonos
Affiliation:1. Department of Neurosciences, Sciences NPSRR, University of Padova, , Padova, Italy;2. Department of Neurology, “Saint Andrew's” State General Hospital of Patras, , Patras, Greece;3. Department of Medicine, Division of Clinical Oncology, University Hospital of Patras, , Rion‐Patras, Greece;4. Unit of Neuro‐Oncology, Hospital Universitari de Bellvitge‐ICO Duran i Reynals, , Barcelona, Spain;5. Department of Surgery and Translational Medicine, University of Milan‐Bicocca, , Monza, Italy;6. CEMES, EMG Unit, Data Medica Group, , Padova, Italy;7. Istituto Oncologico Veneto, IRCCS, , Padova, Italy;8. Department of Oncology, S. Gerardo Hospital, , Monza, Italy
Abstract:This prospective study sought to identify the potential reversibility of oxaliplatin‐induced peripheral neuropathy (OXAIPN) by following‐up its long‐term course 2 years after discontinuation of oxaliplatin (OXA)‐based chemotherapy. Participants were 91 colorectal cancer patients treated with OXA‐based chemotherapy. Neurological assessment, clinical Total Neuropathy Score© (TNSc©) and nerve conduction studies were performed at baseline (T0), the end of chemotherapy (T1) and 2 years (T2) after discontinuation of chemotherapy. A total of 73 of 91 (80%) patients experienced OXAIPN at T1. At a median follow‐up of 25 months, persistence of chronic OXAIPN was present in 61 of 73 patients (84%) and complete resolution was present in 12 patients (17%). Longitudinal comparison of TNSc© values between T1 and T2 revealed that the overall severity of OXAIPN in those 61 patients significantly decreased over time. Median TNSc© values were nine (range: 2–15) at T1 vs. four (range: 2–12) at T2 (P < 0.001). Likewise, sensory nerve conduction measures at T2 significantly improved in all sensory nerves tested, compared with T1. Severity of OXAIPN at T2 was significantly associated (P < 0.001) with high severity of OXAIPN at T1. In conclusion, persistence of OXAIPN beyond 2 years after finishing chemotherapy is common. Clinical and neurophysiological improvement is observed, although recovery is often incomplete.
Keywords:chronic oxaliplatin‐induced peripheral neuropathy  long‐term course  neurotoxicity  oxaliplatin  Total Neuropathy Score©  (TNS©  )
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