Cisplatin neuropathy: a prospective clinical and electrophysiological study in Chinese patients with ovarian...

Nineteen Chinese patients with stage III or IV epithelial ovarian carcinoma by the criteria established by the International Federation of Gynaecology and Obstetrics, treated with cisplatin, 120 mg/m2, every 4 weeks for a maximum of twelve courses if possible, were studied prospectively with clinical and electrophysiological evaluation before and 3, 6, 9 and 12 months during cisplatin administration. Neuropathy occurred in 12 of the 19 patients at the cumulative dose of 360 mg/m2. Up to 89% of the patients assessed in their final examination developed neuropathy. Decreased vibration sensation at the ankles and depressed ankle reflexes were the early manifestations. Electrophysiological findings consisted of low amplitude sensory action potentials of median, ulnar and sural nerves, and slowing of their sensory nerve conduction velocities. Despite substantial involvement of sensory nerves, there was little change in motor nerve conduction velocities or motor unit action potentials. The progression of the neuropathy was unpredictable and could be delayed. As cisplatin is highly effective in the treatment of the tumour which is invariably fatal, if inadequately treated, patient selection with regard to neurotoxicity is unnecessary.