Oxaliplatin-induced painful neuropathy--flicker of hope or hopeless pain?

摘要

Oxaliplatin is a third-generation organoplatinum compound with significant activity against colorectal cancer. Unlike other platinum compounds oxaliplatin induces an acute form of painful neuropathy which appears soon after administration and is often transient and reversible within days. The patients suffer from extremity and perioral paresthesias and in particular from severe cold hypersensitivity. After multiple cycles 70% of the patients develop a clinically different peripheral neuropathy that is characterized by a sensory axonal nerve damage closely resembling that induced by cisplatin. This chronic neuropathy can become very disabling and is, in fact often a limiting factor for escalating chemo-therapeutic dose. For this reason, it would be very valuable to predict oxaliplatin neurotoxicity early in the course of treatment.