Early predictors of peripheral neurotoxicity in cisplatin and paclitaxel combination chemotherapy.
BACKGROUND
We investigated the possible use of clinical signs of chemotherapy-induced peripheral neurotoxicity (CIPN) or of nerve growth factor (NGF) circulating levels to predict the final outcome of CIPN.


METHODS
Sixty-two women affected by locally advanced squamous cervical carcinoma treated with TP (paclitaxel 175 mg/m2 over a 3 h infusion plus cisplatin 75 mg/m2) or TIP (TP plus ifosphamide 5 mg/m2) were examined and scored according to the Total Neuropathy Score (TNS), before and during chemotherapy.


RESULTS
A correlation with the final severity of CIPN was observed with vibration perception and deep tendon reflex evaluation, while pin sensibility, strength, and autonomic symptoms and signs were not informative. A highly significant correlation existed between the decrease in circulating levels of NGF and the severity of CIPN (r = -0.579; P < 0.001; 95% confidence limits -0.702 to -0.423). However, circulating levels of NGF were not effective as predictors of the final neurological outcome of each patient.


CONCLUSIONS
Our study indicates that a precise clinical evaluation of the peripheral nervous system of patients treated with platinum and taxane combination polychemotherapy not only gives reliable information regarding the course of CIPN, but also can be used to predict the final neurological outcome of the treatment.
Cavaletti
G
G
Dipartimento di Neuroscienze e Tecnologie Biomediche, Università di Milano Bicocca, Monza, Italy. guido.cavaletti@unimib.it
Bogliun
G
G
Marzorati
L
L
Zincone
A
A
Piatti
M
M
Colombo
N
N
Franchi
D
D
La Presa
M T
MT
Lissoni
A
A
Buda
A
A
Fei
F
F
Cundari
S
S
Zanna
C
C
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D020932:Nerve Growth Factor / Q000097:blood; D020258:Neurotoxicity Syndromes / Q000209:etiology*; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D011237:Predictive Value of Tests; D011379:Prognosis; D012678:Sensation Disorders / Q000139:chemically induced; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy
D020932:Nerve Growth Factor; D017239:Paclitaxel; D002945:Cisplatin