奥沙利铂诱导的急性神经毒性在重复输注周期之间恢复：一项轴突兴奋性重复多次测量研究。
Oxaliplatin-induced Acute Neurotoxicity Recovers Between Repeat Infusion Cycles: An Axonal Excitability Repeated Multiple Measurements Study.
作者信息
Kokotis Panagiotis, Papantoniou Michail, Carr Richard W, Schmelz Martin, Siakavella Dimitra, Skafida Efthymia, Papadimitriou Christos
机构信息
Laboratory of Clinical Neurophysiology, First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Department of Experimental Pain Research, MCTN Mannheim, University of Heidelberg, Heidelberg, Germany.
出版信息
Cancer Diagn Progn. 2024 May 3;4(3):320-325. doi: 10.21873/cdp.10327. eCollection 2024 May-Jun.
BACKGROUND/AIM: Oxaliplatin, a platinum-based chemotherapy used in the treatment of colorectal cancer, induces acute neurotoxicity following infusion. The aim of this study was to establish whether alterations in axonal excitability develop progressively with higher cumulative doses and whether there is a recovery in motor axons after each cycle of treatment.
PATIENTS AND METHODS
Twenty consecutive patients with a colorectal cancer diagnosis, referred from the Oncology Department of Aretaieion Hospital of Athens, were enrolled in this study between October 2018 and May 2019. None of the participants had diabetes, alcohol abuse, known neuropathy or were previously treated with another neo-adjuvant therapy. Threshold Tracking techniques and Qtrac software were used for assessing axonal excitability in motor axons. Excitability recordings were undertaken before and immediately after the end of oxaliplatin infusion.
RESULTS
Statistically significant changes were found (p<0.01) in axonal excitability (relative refractory period, refractoriness at 2 ms and 2.5 ms, sub-excitability and super-excitability) before and after oxaliplatin infusion. No statistically significant changes (p>0.05) were found in threshold electrotonus and strength-duration parameters before and after oxaliplatin infusion. We also did not find statistically significant differences (p>0.05) between means of excitability parameters before infusion at each cycle.
CONCLUSION
Our study confirms oxaliplatin-induced acute neurotoxicity following infusion and suggests that motor axons recover between repeat infusion cycles.
背景/目的：奥沙利铂是一种用于治疗结直肠癌的铂类化疗药物，输注后会诱发急性神经毒性。本研究的目的是确定轴突兴奋性的改变是否会随着累积剂量的增加而逐渐发展，以及在每个治疗周期后运动轴突是否会恢复。
患者与方法
2018年10月至2019年5月期间，连续纳入了20例来自雅典阿雷泰翁医院肿瘤科的结直肠癌确诊患者。所有参与者均无糖尿病、酗酒、已知的神经病变，且此前未接受过其他新辅助治疗。采用阈值跟踪技术和Qtrac软件评估运动轴突的轴突兴奋性。在奥沙利铂输注开始前和结束后立即进行兴奋性记录。
结果
奥沙利铂输注前后，轴突兴奋性（相对不应期、2 ms和2.5 ms时的不应期、亚兴奋性和超兴奋性）有统计学显著变化（p<0.01）。奥沙利铂输注前后，阈下电紧张和强度-时间参数无统计学显著变化（p>0.05）。我们也未发现每个周期输注前兴奋性参数均值之间存在统计学显著差异（p>0.05）。
结论
我们的研究证实了奥沙利铂输注后会诱发急性神经毒性，并表明运动轴突在重复输注周期之间会恢复。
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