Long-Term Neuropathy After Oxaliplatin Treatment: Challenging the Dictum of Reversibility
| العنوان: | Long-Term Neuropathy After Oxaliplatin Treatment: Challenging the Dictum of Reversibility |
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| المؤلفون: | Matthew C. Kiernan, Susanna B. Park, David Goldstein, Michael Friedlander, Arun V. Krishnan, Cindy S.-Y. Lin |
| المصدر: | The Oncologist. 16:708-716 |
| بيانات النشر: | Oxford University Press (OUP), 2011. |
| سنة النشر: | 2011 |
| مصطلحات موضوعية: | Adult, Male, Cancer Research, medicine.medical_specialty, Pediatrics, Organoplatinum Compounds, Oxaloacetates, Long term follow up, Population, Treatment outcome, Antineoplastic Agents, Deoxycytidine, Neurological assessment, Quality of life, health services administration, Surveys and Questionnaires, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, education, neoplasms, Capecitabine, Aged, education.field_of_study, business.industry, Middle Aged, digestive system diseases, Surgery, Oxaliplatin, Natural history, stomatognathic diseases, Treatment Outcome, Oncology, Symptom Management and Supportive Care, Sensation Disorders, Cohort, Female, Neurotoxicity Syndromes, Fluorouracil, business, therapeutics, medicine.drug |
| الوصف: | Learning Objectives After completing this course, the reader will be able to: Define the symptoms of sensory neurotoxicity in oxaliplatin-treated patients and identify the long-term natural history of nerve dysfunction as a long-lasting complication of treatment that does not necessarily resolve within 6 months.Use sensory excitability techniques to predict long-standing changes in sensory nerve function produced by oxaliplatin. CME This article is available for continuing medical education credit at CME.TheOncologist.com Objectives. Oxaliplatin-induced neuropathy is a significant and dose-limiting toxicity that adversely affects quality of life. However, the long-term neurological sequelae have not been adequately described. The present study aimed to describe the natural history of oxaliplatin-induced neuropathy, using subjective and objective assessments. Methods. From a population of 108 oxaliplatin-treated patients referred for neurological assessment in 2002–2008, 52.2% of the surviving patient cohort (n = 24) was available for follow-up at a median of 25 months post-oxaliplatin. Patients underwent a protocol that incorporated clinical assessment scales, patient questionnaires, standard electrodiagnostic assessments, and novel nerve excitability studies to precisely assess nerve function. Results. At follow-up, 79.2% of patients reported residual neuropathic symptoms, with distal loss of pin-prick sensibility in 58.3% of patients and loss of vibration sensibility in 83.3% of patients. Symptom severity scores were significantly correlated with cumulative dose. There was no recovery of sensory action potential amplitudes in upper and lower limbs, consistent with persistent axonal sensory neuropathy. Sensory excitability parameters had not returned to baseline levels, suggesting persisting abnormalities in nerve function. The extent of excitability abnormalities during treatment was significantly correlated with clinical outcomes at follow-up. Conclusions. These findings establish the persistence of subjective and objective deficits in oxaliplatin-treated patients post-oxaliplatin, suggesting that sensory neuropathy is a long-term outcome, thereby challenging the literature on the reversibility of oxaliplatin-induced neuropathy. |
| تدمد: | 1549-490X 1083-7159 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4f0e43e61c08c3369f5d45c8b53c6dfcTest https://doi.org/10.1634/theoncologist.2010-0248Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....4f0e43e61c08c3369f5d45c8b53c6dfc |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1549490X 10837159 |
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