The incidence of acute oxaliplatin-induced neuropathy and its impact on treatment in the first cycle: a systematic review.
The incidence of acute oxaliplatin-induced neuropathy and its impact on treatment in the first cycle: a systematic review.
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DOI：
10.1186/s12885-018-4185-0
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发表时间：
2018-04-12
期刊：
影响因子：
3.8
通讯作者：
Mahns DA
中科院分区：
文献类型：
--
作者：
Gebremedhn EG;Shortland PJ;Mahns DA
尽管急性奥沙利铂诱导的神经病（OXIPN）通常被认为是一过性的，但最近的研究报告了四分之一患者在奥沙利铂首次给药后输注时间延长、剂量降低和治疗停止。急性OXIPN也是慢性神经病的一个公认的风险因素。然而，在急性期（≤ 14天），这些参数报告不足。本文系统地回顾了急性OXIPN的发生率及其对第一周期治疗的影响。使用PubMed和Medline进行系统性文献检索。如果已发表的原始文章描述了奥沙利铂诱导的急性神经病变患病率的详细信息，则将其纳入。对14项研究（包括6211例患者）进行了评价。大多数患者接受奥沙利铂联合亚叶酸和氟尿嘧啶（FOLFOX）治疗。大多数研究使用国家癌症研究所常见毒性标准来评估急性神经病变。急性神经病变（1-4级）是最常见的事件，患病率范围为4- 98%，其次分别为血液学（1.4-81%）和胃肠道（1.2-67%）毒性。药物方案、奥沙利铂的起始剂量和神经病变评估工具在研究中各不相同。此外，在接受大剂量奥沙利铂（> 85 mg/m2）和/或联合用药的患者中，中度至重度毒性较为常见。大多数研究未报告影响急性神经病变的因素，即诱发急性神经病变所需的范围（最小）剂量、患者和临床风险因素。此外，未系统报告急性期内接受延长输注、剂量降低、治疗延迟和治疗停止的患者数量。尽管关于奥沙利铂起始剂量、药物方案、神经病变评估工具和研究设计的研究存在异质性，但大量患者发生急性神经病变。为了制定更好的急性/慢性神经病变的预防和治疗指南，应使用标准化神经病变评估工具在大型患者队列中进行前瞻性研究，包括药物治疗方案、产生急性神经病变的起始/范围（最小）剂量、治疗依从性、患者和临床风险因素。
Although acute oxaliplatin-induced neuropathy (OXIPN) is frequently regarded to be transient, recent studies have reported prolongation of infusion times, dose reduction and treatment cessation following the first dose of oxaliplatin in quarter of patients. Acute OXIPN is also a well-established risk factor for chronic neuropathy. However, there is underreporting of these parameters during the acute phase (≤ 14 days). This paper systematically reviews the incidence of acute OXIPN and its impact on treatment in the first cycle. A systematic literature search was performed using PubMed and Medline. Published original articles were included if they described details about prevalence of oxaliplatin-induced acute neuropathy. Fourteen studies, comprised of 6211 patients were evaluated. The majority of patients were treated with oxaliplatin in combination with leucovorin and fluorouracil (FOLFOX). Most studies used the National Cancer Institute Common Toxicity Criteria to assess acute neuropathy. Acute neuropathy (Grades 1–4) was the most common event with prevalence ranging from 4–98%, followed by haematological (1.4–81%) and gastrointestinal (1.2–67%) toxicities, respectively. Drug regimens, starting dose of oxaliplatin and neuropathy assessment tools varied across studies. In addition, moderate to severe toxicities were common in patients that received a large dose of oxaliplatin (> 85 mg/m2) and/ or combined drugs. The majority of studies did not report the factors affecting acute neuropathy namely the range (minimal) doses required to evoke acute neuropathy, patient and clinical risk factors. In addition, there was no systematic reporting of the number of patients subjected to prolonged infusion, dose reduction, treatment delay and treatment cessation during the acute phase. Despite the heterogeneity of studies regarding oxaliplatin starting dose, drug regimen, neuropathy assessment tools and study design, a large number of patients developed acute neuropathy. To develop a better preventive and therapeutic guideline for acute/chronic neuropathy, a prospective study should be conducted in a large cohort of patients in relation to drug regimen, starting/ranges (minimal) of doses producing acute neuropathy, treatment compliance, patient and clinical risk factors using a standardised neuropathy assessment tool.
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