title: Impact of oxaliplatin-induced neuropathy: a patient perspective.
abstract: BACKGROUND
  Dose-limiting neurotoxicity is a major side effect of oxaliplatin treatment, producing initial acute neurotoxicity and chronic neuropathy with increasing exposure. The improvement in survival for patients with early-stage colorectal cancer treated with oxaliplatin has highlighted the need for valid and reliable assessment of peripheral neuropathy.
  
  
  OBJECTIVE
  The objective of this paper was to explore neuropathic symptoms in oxaliplatin-treated patients as assessed using different methods.
  
  
  METHODS
  Consecutive symptomatic patients reporting peripheral neuropathy after oxaliplatin chemotherapy for colorectal cancer were interviewed using a semi-structured clinical interview. Neurotoxicity was also assessed using the National Cancer Institute Common Toxicity Criteria scale (clinician-rated), patient 'self-report' questionnaires (PNQ), nerve conduction and clinical assessment.
  
  
  RESULTS
  Twenty patients were assessed, 12.6 ± 2.8 months after treatment cessation (mean cumulative oxaliplatin dose, 789 mg/m(2)). In 40% of patients, neurotoxicity necessitated early cessation of treatment. Only 10% of patients were designated by clinicians with severe neurotoxicity, whilst, in contrast, patient interviews and self-report questionnaires described significant physical limitations due to neuropathic symptoms in 60% of patients. The majority (85%) of patients had objective evidence of sensory neuropathy with nerve conduction studies. Reports from clinical interviews were strongly correlated with patient self-assessment (Pearson coefficient = 0.790, p < 0.0005).
  
  
  CONCLUSIONS
  Given the discrepancies in symptom prevalence highlighted by these findings, the monitoring of oxaliplatin-induced neurotoxicity would benefit from more informative clinical assessment, with inclusion of patient-reported outcome measures. Such an approach would be beneficial in a clinical trial setting to monitor the efficacy of interventions and in prospective studies of survivorship to determine the true burden of peripheral neuropathy in oxaliplatin-treated patients.
authors.affiliation: NSW Cancer Survivors Centre, University of New South Wales, Sydney, NSW, Australia. b.bennett@unsw.edu.au
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Bennett
authors.forename: Susanna B
authors.initials: SB
authors.lastname: Park
authors.forename: Cindy S-Y
authors.initials: CS
authors.lastname: Lin
authors.forename: Michael L
authors.initials: ML
authors.lastname: Friedlander
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Kiernan
authors.forename: David
authors.initials: D
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D000077150:Oxaliplatin; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin