Profile of neurotoxicity of oxaliplatin in young versus elderly patients treated for colorectal carcinoma
Authors: H. Aliane, S. Ghomari-Bezzar
Journal: Annals of Oncology (2018)

Introduction: Peripheral neuropathy secondary to oxaliplatin is very frequent, these neuropathies are characterized by the symmetry of the neurological disorders and their distal predominance. In most patients, this neuropathy is only partially reversible and can persist long after the stop of chemotherapy. This is one of the major dose-limiting side effects of chemotherapy that may lead not only to the loss of function physical activity associated with a decrease in the quality of life and difficulties in daily activities, especially if it is an elderly person but which can also result in the reduction and or delay of the administration dose or even in the worst Of the cases the stop of the treatment. Methods: This is a prospective descriptive, analytical and comparative study that includes elderly and young patients with colorectal cancer treated with oxaliplatin-based chemotherapy whose main objective is to compare the characteristics of neurotoxicity and its impact on the quality of life between the elderly and the young. Results: We collected 30 patients. 16 versus 14 were elderly. 75 versus 28% were female in the elderly patients. The mean age was 47 [26-59] versus 65 years [61-68]. 68 versus 78% in elderly patients were treated for localised colorectal carcinoma. A total of oxaliplatin-based cures 103 versus108 in the elderly (XELOX: 81 versus 85% in the elderly patients)at the total dose or 130 mg/m2(50 versus 59% in the elderly patients) were administered with an average of 3 cures per patient [3-12]. Peripheral neuropathy was reported in 77/103 versus 81/108 cycles in the elderly patients, after the 1st cure (62 versus 44% in the elderly patients) after the 2nd and 3rd cures (31 versus 56%). Peripheral neuropathy occurs on the first day after the cycle (45/77) versus (52/81) cycles in the elderly patients, with swarming (66/77) versus (72/81) de grade I (47/77) versus (56/81) (92/109), spontaneous (55/77) versus (60/81) located at the hands, feet and the perioral region (57/77) versus (60/81), symmetrical in 100% of the case with persistence of the symptomatology at least one week (47/77) versus (54/81) in the elderly patients. Clinical examination revealed motor function and osteo-tendinous reflexes conserved. We noted an episode of laryngeal spasm in a young patient. Clinical examination revealed motor function and osteo-tendinous reflexes conserved. Our conduct was to prolong the duration of the oxaliplatin infusion at 4 hours and a vitamin supplement medication or pregabalin in 30 versus 21% in the elderly and we definitely stopped treatment in 01 versus 02 elderly patients. Despite all its measures 18 versus 14% of elderly patients had an impact on the quality of life namely a limitation of daily activities. Neurotoxicity persisted even after the end of treatment. Conclusion: Neurotoxicity induced by the oxaliplatin is the limiting factor in treatment in patients with colorectal carcinoma. Its severity in its character persistent and evolutionary even after the stop of the treatment, its early detection is capital and can modify the subsequent therapeutic management in order to limit or to regress the induced disorders.