title: Incidence of atypical acute nerve hyperexcitability symptoms in oxaliplatin-treated patients with colorectal cancer.
abstract: BACKGROUND
  Peripheral, acute or chronic, neurotoxicity is one of the main dose-limiting adverse effects of oxaliplatin (OXA). Acute neurotoxicity is typically characterized by distal and perioral cold-induced paresthesias and dysesthesias, but other uncommon symptoms might also be present.
  
  
  OBJECTIVE
  The aim of this post hoc analysis of data extracted from a prospective, multicenter study was to assess the incidence of uncommon acute OXA neurotoxicity symptoms in patients undergoing OXA-based chemotherapy.
  
  
  METHODS
  One hundred chemotherapy-naïve patients (62 males, 38 females, aged 64.7 ± 8.7 years) with colorectal cancer scheduled to receive OXA-based therapy (FOLFOX-4, FOLFOX-6, and XELOX) underwent neurologic evaluation after the 1st infusion and then after 3 and 6 months of OXA-based chemotherapy (after 6th or 4th and 12th or 8th cycles, respectively, according to regimen). At evaluation, patients were asked to report the presence and characteristics of acute hyperexcitability symptoms.
  
  
  RESULTS
  Eighty-two patients presented typical symptoms of acute OXA neurotoxicity in the form of cold-induced paresthesias and dysesthesias. In 45/82 (54.9 %) of patients, uncommon symptoms were also present; shortness of breath (32 %), jaw spasm (26 %), fasciculations (25 %), cramps (20 %), and difficulty in swallowing (18 %) were more frequently reported, while voice (4 %) and visual changes, ptosis and pseudolaryngospasm (1 %) occurred rarely. No significant correlation was disclosed between acute OXA neurotoxicity and chemotherapy regimen, cumulative dose of OXA or patients' age.
  
  
  CONCLUSIONS
  A high percentage of patients treated with OXA-based chemotherapy develop acute neurotoxicity also with uncommon manifestations. Since OXA acute neurotoxicity might be related to the onset of chronic neurotoxicity, these patients should be closely monitored to avoid this dose-limiting adverse effect.
authors.affiliation: Department of Neurosciences, University of Padova, Padua, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Lucchetta
authors.forename: Sara
authors.initials: S
authors.lastname: Lonardi
authors.forename: Francesca
authors.initials: F
authors.lastname: Bergamo
authors.forename: Paola
authors.initials: P
authors.lastname: Alberti
authors.forename: Roser
authors.initials: R
authors.lastname: Velasco
authors.forename: Andreas A
authors.initials: AA
authors.lastname: Argyriou
authors.forename: Chiara
authors.initials: C
authors.lastname: Briani
authors.forename: Jordi
authors.initials: J
authors.lastname: Bruna
authors.forename: Marina
authors.initials: M
authors.lastname: Cazzaniga
authors.forename: Diego
authors.initials: D
authors.lastname: Cortinovis
authors.forename: Guido
authors.initials: G
authors.lastname: Cavaletti
authors.forename: Haralabos P
authors.initials: HP
authors.lastname: Kalofonos
mesh_terms: D000208:Acute Disease; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D000069287:Capecitabine; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D003680:Deglutition Disorders / Q000139:chemically induced; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004334:Drug Administration Schedule; D004417:Dyspnea / Q000139:chemically induced; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D015994:Incidence; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000453:epidemiology / Q000209:etiology*; D009944:Organoplatinum Compounds / Q000008:administration & dosage* / Q000009:adverse effects*; D000077150:Oxaliplatin; D010071:Oxaloacetates; D010292:Paresthesia / Q000139:chemically induced; D011446:Prospective Studies; D013035:Spasm / Q000139:chemically induced
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D010071:Oxaloacetates; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil