title: Preventive effect of traditional Japanese medicine on neurotoxicity of FOLFOX for metastatic colorectal cancer: a multicenter retrospective study.
abstract: BACKGROUND
  A combination of 5-fluorouracil/folinic acid plus oxaliplatin (FOLFOX) is a standard regimen for the chemotherapy of metastatic colorectal cancer. The major dose-limiting toxic effect of oxaliplatin is neurotoxicity. The aim of this study was to evaluate the preventive effects of traditional Japanese medicines, goshajinkigan and shakuyakukanzoto on oxaliplatin-induced neurotoxicity with FOLFOX.
  
  
  METHODS
  Between July 2006 and November 2008, a total of 44 patients with metastatic colorectal cancer received modified FOLFOX6 or FOLFOX4, as first-line chemotherapy at three institutions. They concurrently received either goshajinkigan (group A, n=20) or shakuyakukanzoto (group B, n=24) for neurotoxicity reduction.
  
  
  RESULTS
  The median number of treatment cycles and the median cumulative dose of oxaliplatin were 12 cycles (range, 4-19) and 898 mg/m(2) (range, 340-1255) in group A and 10.5 cycles (range, 6-20) and 845 mg/m(2) (range, 510-1480) in group B. Eighteen patients in group A and 24 in group B received oxaliplatin in a cumulative dose exceeding 500 mg/m(2). At a dose of 500 mg/m(2) oxaliplatin, grade 1-2 toxicity occurred in 10 patients of group A and in 7 of group B, but there was no grade 3 or higher toxicity in either group. The response rate of the 38 patients with measurable lesions was 50.0% (9/18) in group A and 65% (13/20) in group B.
  
  
  CONCLUSIONS
  The administration of traditional Japanese medicine may reduce oxalipatin-induced neurotoxicity without negatively affecting tumor response in patients with colorectal cancer who undergo FOLFOX therapy.
authors: Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Toyama, Japan. ayhosoka@med.u-toyama.ac.jp
authors: Ayumu
authors: A
authors: Hosokawa
authors: Kohei
authors: K
authors: Ogawa
authors: Takayuki
authors: T
authors: Ando
authors: Nobuhiro
authors: N
authors: Suzuki
authors: Akira
authors: A
authors: Ueda
authors: Shinya
authors: S
authors: Kajiura
authors: Yuka
authors: Y
authors: Kobayashi
authors: Yuji
authors: Y
authors: Tsukioka
authors: Naoki
authors: N
authors: Horikawa
authors: Kazuhisa
authors: K
authors: Yabushita
authors: Junya
authors: J
authors: Fukuoka
authors: Toshiro
authors: T
authors: Sugiyama
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000068258:Bevacizumab; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006035:Glycyrrhiza; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D020258:Neurotoxicity Syndromes / Q000209:etiology / Q000517:prevention & control*; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D029596:Paeonia; D012189:Retrospective Studies
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal; D009944:Organoplatinum Compounds; C119642:gosha-jinki-gan; C038462:shakuyaku-kanzoh-toh; D000077150:Oxaliplatin; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil