The effect of diabetes on oxaliplatin-induced peripheral neuropathy.
BACKGROUND
Chemotherapy-induced neurotoxicity is a significant source of morbidity for cancer patients. This study aimed to assess the relationship between preexisting diabetes and clinically significant (National Cancer Institute Common Toxicity Criteria grades 2 and 3) OXIPN; between diabetes, and the cumulative dose at onset of OXIPN; and between other preexisting medical conditions and the development of OXIPN.


METHODS
We reviewed medical records of all patients with stage II-IV colon cancer treated in the Albert Einstein Cancer Center, Philadelphia, with oxaliplatin from 2005 to 2009. Exclusion criteria included preexisting neuropathy, previous neurotoxic chemotherapy exposure, and incomplete medical records. The NCI Common Toxicity Criteria was used to grade sensory neuropathy. Univariate analysis was used to estimate odds ratios and confidence limits for prevalence of OXIPN in patients with and without diabetes. The mean level and cumulative doses were compared using the t test.


RESULTS
Sixty-two patients met the study criteria; 23 oxaliplatin-treated patients were excluded. The crude incidence of any OXIPN was 65%. There was no relationship found between development of OXIPN and the presence of diabetes, smoking, hypertension, or statin use. However, the mean cumulative dose of oxaliplatin was significantly lower for patients with diabetes who developed neuropathy, compared with those without diabetes (388 vs. 610 mg/m(2); P = .021).


CONCLUSIONS
Although the presence of diabetes did not appear to affect the severity of OXIPN, patients with diabetes developed OXIPN at a lower cumulative dose of oxaliplatin (P < .05). The results may have implications for treatment of patients with diabetes and colon cancer.
Department of Internal Medicine, Howard University, Washington, DC, USA. ngozi411@yahoo.com
Augusta N
AN
Uwah
Joan
J
Ackler
John C
JC
Leighton
Sherry
S
Pomerantz
William
W
Tester
D000970:Antineoplastic Agents / Q000009:adverse effects*; D002118:Calcium / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000150:complications / Q000188:drug therapy*; D048909:Diabetes Complications / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000009:adverse effects*; D000077150:Oxaliplatin; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000453:epidemiology* / Q000473:pathology; D015143:Philadelphia / Q000453:epidemiology; D011379:Prognosis
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002118:Calcium