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Peripheral neuropathy and low dose cisplatin
1Division of Medical Oncology, Lombardi Cancer Research Center, Georgetown University Medical Center, Washington, D.C. 20007.
American Journal of Clinical Oncology
|December 1, 1988
Summary
Low-dose cisplatin therapy can cause peripheral neuropathy in cancer patients. This sensory neuropathy, characterized by pain and numbness, may be debilitating and minimally reversible even at reduced doses.
Area of Science:
- Oncology
- Neuroscience
- Pharmacology
Background:
- Cisplatin is a widely used chemotherapy agent for various cancers.
- Peripheral neuropathy is a known dose-limiting toxicity of cisplatin.
- The risk of neuropathy with lower cisplatin doses requires further investigation.
Purpose of the Study:
- To evaluate the incidence and characteristics of peripheral neuropathy in patients receiving low-dose weekly cisplatin.
- To assess the reversibility of cisplatin-induced neuropathy.
- To determine if lower cisplatin doses mitigate neurological toxicity.
Main Methods:
- Retrospective analysis of 55 patients with metastatic or unresectable carcinomas.
- Patients received cisplatin at a dose of 20 mg/m2 weekly.
- Neuropathy was assessed based on clinical symptoms and neurological examination.
Main Results:
- Five out of 55 patients (9.1%) developed peripheral neuropathy.
- Neuropathy was primarily sensory, presenting as painful paresthesias and numbness in a "stocking glove" distribution.
- Neuropathy occurred at cumulative doses ranging from 100 to 640 mg/m2 and showed minimal reversibility after drug discontinuation.
Conclusions:
- Low-dose weekly cisplatin can induce significant peripheral neuropathy.
- This neurological toxicity can be debilitating and may not be fully reversible.
- Careful monitoring for neuropathy is essential even with reduced cisplatin dosing regimens.