| Objective: In this study,we investigated the clinical features and early nerve conduction characteristics of oxaliplatin-induced peripheral neuropathy(OXLIPN)by nerve conduction studies and clinical scale assessment.Thus we could early detect and accurate assess the peripheral nerve toxicity of oxaliplatin and guide the prevention of neurotoxicity.Methods: In this study,we selected patients pathologically diagnosed colon cancer in the Department of Oncology the first affiliated hospital of Bengbu medical college from December 2015 to March 2017,which meets the inclusion and exclusion criterias.All patients plan to implement the XELOX program(intravenous infusion of oxaliplatin on first days 130mg/m2,1-14 day oral capecitabine,21 d for 1 cycles)After each cycle of chemotherapy patients with a questionnaire to understand the incidence of acute OXLIPN.Before and after 4 cycles of chemotherapy(1 to 2 days before chemotherapy in the fifth week of admission)all patients underwent nerve conduction studies.we observed the changes of conduction velocity and amplitude for sensory nerve and motor nerve.While after 4 cycles of patients with clinical scale assessment to evaluate chronic OXLIPN and compared with the results of nerve conduction studies.Results:1.In this study,we completed a total of 30 cases,including 16 cases male patients and 14 cases female patients,the average age(58.83 ± 8.63)years,all patients received the expected 4 Periodic chemotherapy and didn't experience fatal toxic events in the course of treatment.2.The overall incidence of acute OXLIPN was 90%.There were 26 cases(86.66%)with cold-induced limb sensory abnormalities,10 cases(33.33%)with cold-induced peritumoral sensory abnormalities,cold-induced throat sensation abnormalities in 8 cases(26.66),mandibular stiffness in 5 cases(16.66%),muscle spasm in 3 cases(10%),laryngeal spasm in 2 cases(6.67%),sound changes in 3 cases(10%),some symptoms such as suffocation,swallowing,Muscle fibrillation,eyelid ptosis,visual changes in the study didn't appear.3.Compared with baseline,after4 cycles of chemotherapy the compound muscle action potentials of motor nerve right median nerve and left peroneal nerve were decreased,the difference was statistically significant(P < 0.05).There was no significant difference between the motor nerve conduction velocity and the amplitude of the each nerve left and right over the same period.After 4 cycles of chemotherapy sensory nerve on both sides,the sural nerve and the median nerve action potential amplitudes were decreased,the difference was statistically significant(P < 0.01),on the right side of the median nerve and the left side of the sural nerve conduction velocity were decreased,the difference was statistically significant(P < 0.05),there was no significant difference between the same nerve on both sides of the amplitude and the conduction velocity(P > 0.05).4.Compared to the abnormal rate of nerve conduction studies in upper and lower limbs after chemotherapy:There was no significant difference between the upper and lower limbs of motor nerves(P > 0.05).There was significant difference between the upper and lower limbs of sensory nerves(P < 0.05).5.After the end of chemotherapy for clinical assessment of patients with chronic neurotoxicity,the abnormal rate was 43.33%,the abnormal rate of nerve conduction studies was 66.67%,difference between the two groups during the same period was statistically significant(P < 0.05).Conclusion:1.The incidence of acute OXLIPN is high through clinical observation;compared with the clinical scale,the detection rate of nerve conduction studies for chronic OXLIPN is higher.2.The early nerve conduction characteristics of chronic OXLIPN are bilateral symmetry,sensory axonal damage,with upper limb injury is important,accompanied by mild motor nerve injury.Nerve conduction studies can early detect subclinical peripheral nerve damage and for early diagnosis to guide the treatment of peripheral nerve toxicity. |
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