Low prevalence of cisplatin-induced neuropathy after 4-day continuous infusion in head and neck cancer.

The toxicity of cisplatin on peripheral nerves was studied using electrophysiologic recordings in 52 patients with head and neck squamous cell carcinoma. Induction chemotherapy (cisplatin: 25 mg/m2/day, days 1-4; 5-fluorouracil: 1 g/m2/day, days 1-4) was administered by continuous infusion every 3 weeks. Electrophysiologic recordings were performed before and after the completion of three courses of chemotherapy (cisplatin total dose: 250-300 mg/m2). The comparison between the recordings showed 14% of the patients had an increase in the latency of the soleus muscle monosynaptic reflex as studied by the Hoffman reflex and 9% showed a decrease in the conduction velocity of the cutaneous sensory fibers of the median nerve. These results indicated a low prevalence of cisplatin-induced neuropathy. The respective roles played by the continuous infusion of the drug and by the potentiation of neurotoxic effects resulting from the association of cisplatin with other neurotoxins is discussed to explain this low toxicity.