Paclitaxel plus carboplatin-induced peripheral neuropathy. A prospective clinical and electrophysiological study in patients suffering from solid malignancies.
OBJECTIVE
The current study intended to determine the incidence, severity and reversibility of paclitaxel plus carboplatin (CP)-induced peripheral neuropathy (CPPN) and to describe its clinical and electrophysiological features.


METHODS
We prospectively studied 21 adult patients scheduled to be treated with 6 courses of cumulative carboplatin plus paclitaxel (CP) regimens for a non-myeloid malignancy. They were followed-up by neurological examination and electrophysiological study during chemotherapy and 3 months after its discontinuation. The severity of neurotoxicity was assessed by means of a modified peripheral neuropathy (PNP) score.


RESULTS
Evidence of CPPN was recorded in 14 of the 21 patients (66.6 %). The sensory symptoms were present in the lower limbs first and then involved the upper limbs. No statistical significance, concerning the changes from baseline to subsequent mean scores in all motor conduction parameters examined,was revealed. By contrast, comparisons of the mean changes at baseline and each of the follow-up studies showed significant decrease in all sensory action potentials examined. The mean PNP scores for patients that manifested some grade of neurotoxicity were 17.9 +/- 9.8. The followup data 3 months after the discontinuation of chemotherapy showed that the CP-induced neuropathy was at least partially reversed.


CONCLUSIONS
CP-induced neuropathy was symmetrical, distal and predominantly sensory in character, though minor to moderate motor signs were only evident in severely affected patients. Reversibility of CP-induced neuropathy was partially observed after the suspension of chemotherapy.
Argyriou
Andreas A
AA
Dept. of Neurology, Laboratory of Clinical Neurophysiology, University of Patras Medical School, P.O. Box 1045, Rion, Patras, Greece. andargyriou@yahoo.gr
Polychronopoulos
Panagiotis
P
Iconomou
Gregoris
G
Koutras
Angelos
A
Kalofonos
Haralabos P
HP
Chroni
Elisabeth
E
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D019540:Area Under Curve; D016190:Carboplatin / Q000009:adverse effects*; D018450:Disease Progression; D004358:Drug Therapy / Q000379:methods; D004594:Electrophysiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology* / Q000628:therapy; D009431:Neural Conduction / Q000187:drug effects / Q000502:physiology / Q000528:radiation effects; D017239:Paclitaxel / Q000009:adverse effects*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000503:physiopathology; D011446:Prospective Studies; D013997:Time Factors
D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel