Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Korea.
Center for Colorectal Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea.
Sci Rep. 2020 May 14;10(1):7995. doi: 10.1038/s41598-020-64511-5.
We set out to determine the usability of serum neurofilament light chain (sNfL), serum glial fibrillary acidic protein (sGFAP), and retinal parameters by using optical coherence tomography (OCT) as reliable biomarkers of the progression of oxaliplatin-induced peripheral neuropathy (OIPN). Forty-three patients scheduled to undergo oxaliplatin-based chemotherapy at the National Cancer Center of Korea between June 2018 and October 2019 were prospectively assessed at baseline, 3 months, and 6 months of chemotherapy. Patients were assessed on clinical scales and underwent OCT, sNfL, and sGFAP level measurement at each follow-up visit. By applying the National Cancer Institute-Common Toxicity Criteria (NCI-CTC), OIPN was classified as grade 1 in 12 (28%) patients, grade 2 in 25 (58%), and grade 3 in 5 (12%) at 6 months of chemotherapy. sNfL levels increased during oxaliplatin administration, while serial sGFAP levels or retinal parameters did not change. Patients with grade-3 OIPN showed significantly higher mean sNfL levels than patients with grade 0-2 OIPN at 6 months of treatment. At 4-6 months after completion of chemotherapy, sNfL levels were significantly reduced compared to the levels at 6 months of chemotherapy. Monitoring of sNfL during chemotherapy can indicate ongoing neuroaxonal injury and the severity of OIPN.
我们旨在通过使用光学相干断层扫描（OCT）确定血清神经丝轻链（sNfL）、血清神经胶质纤维酸性蛋白（sGFAP）和视网膜参数的可用性，作为奥沙利铂诱导的周围神经病变（OIPN）进展的可靠生物标志物。2018 年 6 月至 2019 年 10 月，43 名在韩国国家癌症中心接受奥沙利铂为基础化疗的患者在基线、化疗 3 个月和 6 个月时进行前瞻性评估。患者在每次随访时接受临床量表评估，并进行 OCT、sNfL 和 sGFAP 水平测量。根据国家癌症研究所常见毒性标准（NCI-CTC），43 名患者中有 12 名（28%）在化疗 6 个月时为 OIPN 1 级，25 名（58%）为 2 级，5 名（12%）为 3 级。sNfL 水平在奥沙利铂给药期间升高，而连续 sGFAP 水平或视网膜参数没有变化。在化疗 6 个月时，发生 OIPN 3 级的患者的平均 sNfL 水平明显高于发生 OIPN 0-2 级的患者。在化疗结束后 4-6 个月，sNfL 水平与化疗 6 个月时相比显著降低。化疗期间 sNfL 的监测可以表明持续的神经轴突损伤和 OIPN 的严重程度。
