Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
권호 표지

Oxaliplatin-induced Peripheral Neuropathy in Patients with Advanced or Metastatic Gastric Cancer

진행성 또는 전이성 위암 환자에 있어서 Oxaliplatin 투여로 인한 말초신경통증 분석

  • Park, Ae-Ryoung (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Kim, Soon-Joo (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Bang, Joon-Seok (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • La, Hyen-Oh (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea)
  • 박애령 (가톨릭대학교 서울성모병원 약제부) ;
  • 김순주 (가톨릭대학교 서울성모병원 약제부) ;
  • 방준석 (가톨릭대학교 서울성모병원 약제부) ;
  • 나현오 (가톨릭대학교 서울성모병원 약제부)
  • Received : 2009.03.12
  • Accepted : 2009.06.10
  • Published : 2009.06.30
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Abstract

Oxaliplatin is a tolerable and effective drug of choice in the treatment of advanced or metastatic gastric cancer. However, it has many dose-limiting neurotoxicities. This study was performed to assess the incidence and types of oxaliplatin-related neurotoxicities. Sixty-four patients receiving oxaliplatin-involved regimen as salvage therapy on metastatic gastric cancer or as the first-line therapy on advanced gastric cancer were evaluated during the period between September 1, 2006 and February 29, 2008. The patients were treated with oxaliplatin 100 $mg/m^2$ and leucovorin 100 $mg/m^2$ simultaneously as 2-hour-lasting infusion on Day-1 followed by 5-FU 1200 $mg/m^2$ as a 22-hour-lasting continuous infusion both on Day-1 and Day-2 by every other week. We developed questionnaires to evaluate patient-recognized neurotoxic symptoms rather than the observer-described events. Surveys were completed at bedside or via telephone interview. Acute and chronic neurotoxicities were graded according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC, version 3) as well as the Oxaliplatin-specific Neurotoxicity Scale. The Grade-3 neuropathy was reported in 19% of the patients (n=12) and grade-1/2 neuropathy occurred in 70% (n=45). The most common symptom was cold-related dysesthesia (83%) regarded as nociperception by the patients. Some patients (19%) experienced functional impairment affecting activities of daily living such as writing, buttoning, and walking. Even though 74% of the patients (42/57) were prescribed with gabapentin to reduce these peripheral symptoms, it did not appear to derive any benefit from this medication. It is suggested that notify the patients about their oxaliplatin-associated, debilitating symptoms, and educate them any self-care strategy at the initiating phase of the chemotherapy. Moreover, it needs to design the intervention studies regarding the prevention and management of the peripheral neuropathy.

Keywords

References

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