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Neurotoxicity of FOLFOX-4 as adjuvant treatment for patients with colon and gastric cancer: a randomized study of two different schedules of oxaliplatin

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Abstract

Purpose

The dose limiting toxicity of oxaliplatin (l-HOP) is neurotoxicity, which is characterized by an acute neuropathy and a clinically distinct chronic neuropathy. This randomized study evaluated if prolonged l-HOP infusion over the conventional l-HOP schedule was useful in reducing acute and possibly chronic l-HOP induced neurotoxicity in colon and gastric cancer patients receiving l-HOP-based regimen as adjuvant chemotherapy.

Methods

Sixty-four patients were randomly assigned to group A (26 colon and 6 gastric cancer) and to group B (23 colon and 9 gastric cancer). Chemotherapy in both groups consisted of l-HOP 85 mg/m2 i.v. only on day 1, with leucovorin 100 mg/m2 i.v. as a 2-h infusion followed by bolus 5-fluorouracil (5-FU) 400 mg/m2/day and a 22-h infusion of 5-FU 600 mg/m2/day, repeated for two consecutive days every 2 weeks for a maximum of 12 cycles. Patients in group A received l-HOP as a continuous 6-h i.v. infusion, and patients in group B received l-HOP as the conventional 2-h i.v. infusion.

Results

The percentage of patients presenting with grade ≥2 neurotoxicity was statistically lower in group A than in group B (28.1% vs. 59.3%: P = 0.02). There was a statistically lower percentage of cycles with grade ≥2 neurotoxicity in group A (6.1%) than in group B (18.5%) (P < 0.001).

Conclusions

This study suggests that l-HOP as a continuous 6-h infusion is useful in preventing and reducing acute l-HOP induced neurotoxicity in patients with colon and gastric cancer receiving FOLFOX-4 regimen as adjuvant treatment.

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Acknowledgments

We thank Dr. Stefania Rossi for statistical assistance.

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Authors and Affiliations

  1. Section of Medical Oncology, Department of Human Pathology and Oncology, University of Siena, Policlinico Le Scotte, Viale Bracci 11, 53100, Siena, Italy

    Roberto Petrioli, Alessandra Pascucci, Edoardo Francini, Stefania Marsili, Angela Sciandivasci & Guido Francini

  2. Neurophysiology Unit, Department of Neurological Sciences, University of Siena, Siena, Italy

    Rossana Tassi

  3. Clinical Surgery, University of Siena, Siena, Italy

    Serenella Civitelli & Gabriello Tanzini

  4. General Surgery, University of Siena, Siena, Italy

    Marco Lorenzi

Authors
  1. Roberto Petrioli
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  2. Alessandra Pascucci
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  3. Edoardo Francini
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  4. Stefania Marsili
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  5. Angela Sciandivasci
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  10. Guido Francini
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Corresponding author

Correspondence to Guido Francini.

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Petrioli, R., Pascucci, A., Francini, E. et al. Neurotoxicity of FOLFOX-4 as adjuvant treatment for patients with colon and gastric cancer: a randomized study of two different schedules of oxaliplatin. Cancer Chemother Pharmacol 61, 105–111 (2008). https://doi.org/10.1007/s00280-007-0454-3

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  • DOI: https://doi.org/10.1007/s00280-007-0454-3

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