Ultrasonographic assessment of chemotherapy-induced peripheral neuropathy after oxaliplatin treatment: an exploratory...

BackgroundOxaliplatin is used in colorectal cancer treatment (CRC) but frequently causes chemotherapy-induced peripheral neuropathy (CIPN), a cumulative and potentially chronic adverse event. Reliable non-invasive methods for the early detection and monitoring of CIPN are lacking. Shear wave elastography (SWE) is an ultrasound-based technique that quantifies peripheral nerve stiffness and may enable CIPN assessment.PurposeTo evaluate the feasibility of SWE for detecting CIPN from oxaliplatin treatment in CRC.Material and MethodsIn this prospective, single-blinded study, patients with stage III-IV CRC receiving oxaliplatin-based (n = 18) or non-oxaliplatin chemotherapy (n = 12) were assessed at baseline, 3 months, and 6 months. Tibial nerve SWE, cross-sectional area, and diameter were measured using a standardized ultrasound protocol. CIPN symptoms were recorded through structured interviews, yielding composite scores (0-10), with possible CIPN defined as ≥2 points. Healthy controls (n = 9) underwent a single SWE evaluation. Linear mixed-effects models and non-parametric tests were used for longitudinal and group comparisons.ResultsNerve diameter increased over time in both groups (+1.50 mm, 95% confidence interval = 0.78-2.21; P <0.001) without between-group differences. SWE showed a trend toward higher tibial nerve stiffness at 6 months in oxaliplatin-treated patients (29.75 vs. 20.81 kPa). Possible CIPN occurred in 70% of oxaliplatin-treated patients versus none in the non-oxaliplatin (P <0.01). SWE correlated with CIPN scores (ρ = 0.55; P = 0.04).ConclusionSWE is a feasible, non-invasive method, and tibial nerve stiffness was modestly associated with CIPN symptom severity at 6 months. These findings are hypothesis-generating, and larger studies with validated neuropathy instruments are warranted to confirm clinical utility.