Paclitaxel does not cause central nervous adverse effects: a prospective vigilance-controlled EEG mapping study in ovarian cancer patients.
BACKGROUND
The objective of this study was to evaluate potential adverse effects of paclitaxel-containing chemotherapy on the central nervous system in women with ovarian cancer.


METHODS
Twenty-eight women with histologically confirmed epithelial ovarian carcinoma and treated with combination chemotherapy consisting of paclitaxel and carboplatin were entered into the study. Patients were tested with vigilance-controlled EEG before and after chemotherapy. Additionally, a battery of neuropsychologic tests before, after 3 cycles and at the end of the chemotherapy were performed.


RESULTS
Twenty of the 28 patients responded to chemotherapy (71%). Eleven patients (39%) developed peripheral neurotoxicity. A reduced vigilance in patients with ovarian cancer prior to chemotherapy compared to healthy controls was observed (clearly demonstrated by an attenuated total power, a decrease in fast alpha and slow beta activity, an increase in delta and theta activity as well as a deceleration of the centroid of the total power spectrum). On the other hand, an improved vigilance in patients with ovarian cancer treated with paclitaxel/carboplatin was observed (demonstrated by an increase in total power and an increase in beta power, being more pronounced in the right than in the left hemisphere, between pre- and post-treatment). The results of EEG mapping concurred with those of psychometric tests. The test results did not deteriorate during chemotherapy. A statistically significant improvement in the alphabetical crossout test from the first to the third measurement was observed, indicating an improvement in short-term attention, concentration and the constancy of work during chemotherapy.


CONCLUSIONS
Combination chemotherapy consisting of paclitaxel and carboplatin does not cause encephalopathy, but a trend towards an improved vigilance and an improvement of short-term attention and concentration was observed in patients with ovarian cancer after chemotherapy.
Mayerhofer
K
K
Department of Gynecology & Obstetrics, University of Vienna Medical School, Austria. klaus.mayerhofer@akh-wien.ac.at
Bodner
K
K
Saletu
B
B
Bodner-Adler
B
B
Anderer
P
P
Hefler
L
L
Kaider
A
A
Leodolter
S
S
Kainz
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001143:Arousal / Q000187:drug effects*; D001288:Attention / Q000187:drug effects; D001921:Brain / Q000187:drug effects*; D001931:Brain Mapping; D016190:Carboplatin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004569:Electroencephalography / Q000187:drug effects*; D005071:Evoked Potentials / Q000187:drug effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D009483:Neuropsychological Tests; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D017239:Paclitaxel / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies
D016190:Carboplatin; D017239:Paclitaxel