Department of Neurology, St. Josef Hospital, Ruhr-University Bochum, Germany.
Department of Hematology, Oncology and Palliative Care, St. Josef Hospital, Ruhr-University Bochum, Germany.
J Neuroimaging. 2019 Jan;29(1):133-139. doi: 10.1111/jon.12557. Epub 2018 Sep 10.
Oxaliplatin-induced neuropathy is a major dose limiting side effect of the highly effective combination chemotherapy with oxaliplatin, irinotecan, and 5-fluorouracil (FOLFIRINOX) in patients with metastastic pancreatic cancer. We present the first longitudinal sonographical-electrophysiological study on oxaliplatin-induced neuropathy.
Thirteen patients with metastatic pancreatic cancer underwent clinical, sonographic, and electrophysiological evaluation before, 3 and 7 months after treatment with 12 two-week cycles of FOLFIRINOX.
The majority of patients (61%) developed symptoms and electrophysiological signs of a length-dependent sensorimotor axonal neuropathy 7 months after treatment initiation. Oxaliplatin-induced neuropathy presented with a cross-sectional area (CSA) increase of mostly the tibial and fibular nerve, which developed parallel or prior to clinical signs and electrophysiological changes. Furthermore, isolated CSA at entrapment sites of the upper and lower extremities was measured without relevant symptoms. No correlation between sonographic and electrophysiological findings or clinical severity was detected.
Oxaliplatin-induced neuropathy is characterized by an axonal length-dependent nerve affection presenting with a combination of sonographical and electrophysiological alterations.
奥沙利铂诱导的周围神经病是转移性胰腺癌患者接受奥沙利铂、伊立替康和氟尿嘧啶（FOLFIRINOX）联合化疗的主要剂量限制的副作用。我们首次进行了奥沙利铂诱导的周围神经病的纵向超声电生理研究。
13 例转移性胰腺癌患者在接受 FOLFIRINOX 治疗的 12 个两周周期之前、3 个月和 7 个月进行了临床、超声和电生理评估。
大多数患者（61%）在治疗开始后 7 个月出现了症状和电生理表现的长度依赖性感觉运动轴索性神经病。奥沙利铂诱导的周围神经病表现为胫骨和腓骨神经的横截面积（CSA）增加，这些改变与临床症状和电生理改变平行或先于其出现。此外，还测量了上肢和下肢压迫部位的孤立 CSA，而没有相关症状。未发现超声和电生理发现或临床严重程度之间存在相关性。
奥沙利铂诱导的周围神经病的特征是轴突长度依赖性的神经病变，表现为超声和电生理改变的组合。
