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Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity
07:42

Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity

Published on: April 26, 2012

Oxaliplatin and axonal Na+ channel function in vivo

Arun V Krishnan1, David Goldstein, Michael Friedlander

  • 1Institute of Neurological Sciences, Prince of Wales Hospital, Sydney, New South Wales, Australia.

Clinical Cancer Research : an Official Journal of the American Association for Cancer Research
|August 11, 2006
PubMed
Abstract

Insights

Oxaliplatin treatment causes neurotoxicity by affecting axonal sodium channels, leading to nerve dysfunction. Clinical nerve excitability tests can detect early signs of this chemotherapy side effect.

Area of Science:

  • Neuroscience
  • Clinical Pharmacology
  • Oncology

Background:

  • Oxaliplatin is a platinum-based chemotherapy agent widely used for colorectal cancer.
  • Neurotoxicity is a common and dose-limiting side effect of oxaliplatin treatment.
  • The precise mechanisms underlying oxaliplatin-induced neurotoxicity remain incompletely understood.

Purpose of the Study:

  • To investigate the pathophysiology of oxaliplatin-induced neurotoxicity.
  • To utilize clinical nerve excitability techniques to assess axonal ion channel function in patients treated with oxaliplatin.

Main Methods:

  • Combined nerve excitability studies with standard nerve conduction studies and clinical assessments.
  • Evaluated 22 patients undergoing treatment with oxaliplatin over 89 treatment cycles.
  • Recorded excitability parameters before and immediately after oxaliplatin infusions.

Main Results:

  • Significant increases in refractoriness and relative refractory period were observed post-infusion, indicating an effect on axonal sodium (Na+) channels.
  • Patients who developed chronic neuropathy exhibited significantly greater changes in excitability parameters.
  • Following treatment cessation, 41% of patients had persistent symptoms and nerve conduction abnormalities.

Conclusions:

  • Oxaliplatin-induced neurotoxicity is mediated by an effect on axonal sodium channels.
  • Clinical nerve excitability techniques show promise for early detection of neurotoxicity.
  • These techniques may aid in evaluating prophylactic therapies for oxaliplatin neurotoxicity.

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