ABSTRACT
PURPOSE: Oxaliplatin is a platinum compound widely used in gastrointestinal cancer treatment but produces dose-limiting peripheral neuropathy. New insights into oxaliplatin-induced peripheral neuropathy (OIPN) assessment are needed to detect more effectively this condition. In this context, we conducted Canaloxa study, a prospective preliminary clinical trial that aimed to investigate how Electrochemical Skin Conductance (ESC), a parameter used in small fiber neuropathy assessment, could be helpful in OIPN diagnosis. METHODS: Cancer patients treated for at least three months with oxaliplatin and suffering from clinically OIPN were included. Electrochemical Skin Conductance, thermal thresholds, and neuropathic pain were assessed in all included patients. RESULTS: During one year, 36 patients were included. The main result was the correlation between ESC and Neuropathic Pain Symptom Inventory score for hands (rho value = -0.69, p < 0.0001) and feet (rho value = -0.79, p < 0.0001). ESC values were lower in neuropathic patients with painful symptoms than in ones without painful symptoms (p = 0.0003 and p < 0.0001 for hands and feet, respectively). No correlation was observed between ESC and thermal thresholds. CONCLUSION: These preliminary data suggest that ESC could be a useful objective marker of painful oxaliplatin-induced neuropathy and could complement the use of subjective clinical scales. This study was prospectively registered on clinicaltrials.gov (NCT02827916) before patient recruitment has begun.
ABSTRACT
PURPOSE: Oxaliplatin is a platinum derivate widely used in cancer treatment but producing dose-limiting peripheral neurotoxicity. Acute neuropathy is characterized by a transient cold-induced distal allodynia, whereas chronic neuropathy leads to sensory loss. To design a method for quantitative assessment of oxaliplatin-induced peripheral neuropathy, we developed a study that aims to characterize the most appropriate skin area of the hand to perform sensory tests. METHODS: We included patients treated for at least 6 months with oxaliplatin. Thermal sensory tests are assessed using the Thermotest (Somedic) and consist in measuring thermal thresholds in the thenar and in the fingertips of the opposite hand. Results are analyzed using T-Tests comparing thermal sensory thresholds between the two areas of the hand, globally and then individually. RESULTS: In 7 weeks, 12 patients (7 men and 5 women; mean age: 64.5 years) were included, all treated with FOLFOX protocol. Thermal detection thresholds measured on the fingertips are 146% and 108% greater than the ones measured on the palm for cold and warm, respectively (P < 0.0001). Thermal pain thresholds are difficult to interpret. Regarding individual tests, 9/12 patients and 8/12 patients experienced hypesthesia to cold and warm, respectively. CONCLUSIONS: These results reveal that distal hypesthesia occurring under treatment with oxaliplatin is markedly pronounced in the fingertips; however, as thermal threshold is unknown before treatment, it is difficult to assert that fingertip thermal hypesthesia has developed under treatment. Finally, this short study may be useful to design a method for quantifying oxaliplatin-induced neuropathy.
