title: Incidence of cold-induced peripheral neuropathy and dose modification of adjuvant oxaliplatin-based chemotherapy for patients with colorectal cancer.
abstract: BACKGROUND
  The CAPOX regimen is used for adjuvant treatment of colorectal cancer. A well-known side effect of oxaliplatin, which often leads to dose modification (DM), is acute neuropathy (AN). AN is provoked by cold, and it could therefore be expected that the degree of AN and thereby DM is more pronounced in the winter period compared to the summer period.
  
  
  METHODS
  Patients with colorectal cancer who received adjuvant CAPOX from January 2005 to August 2011 were reviewed. Out of 108 patients who received adjuvant CAPOX, the oxaliplatin dose was reduced in 92 (85%) patients due to AN. Seventeen out of 31 (55%) patients already had a DM of oxaliplatin in the second cycle during the winter period (December to February; mean temperature 0.1-1.8°C), while in the summer period (June to August; mean temperature 15.1-16.3°C), only 4 (13%) patients needed DM (OR = 2.5, p = 0.022).
  
  
  CONCLUSIONS
  In this study, we found that the risk of DM and discontinuation of oxaliplatin is highest in the winter period compared to the other seasons. This study draws attention to the importance of training in the proper handling of the acute neurotoxicity of oxaliplatin.
authors.affiliation: Department of Oncology, Hilleroed Hospital, Hilleroed, Denmark.
authors.forename: Rahim
authors.initials: R
authors.lastname: Altaf
authors.forename: Annette
authors.initials: A
authors.lastname: Lund Brixen
authors.forename: Bent
authors.initials: B
authors.lastname: Kristensen
authors.forename: Svend Erik
authors.initials: SE
authors.lastname: Nielsen
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant; D003080:Cold Temperature / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D003718:Denmark / Q000453:epidemiology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004305:Dose-Response Relationship, Drug; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil