Nerve Conduction Velocity Study is Effective in Objectively Assessing Oxaliplatin-induced Peripheral Neuropathy

Oxaliplatin is effective in the treatment of metastatic colorectal cancer patients; however, severe neurotoxicity developed frequently. To assess the efficacy of nerve conduction velocity (NCV) study in objectively assessing oxaliplatin-induced peripheral neuropathy, a pilot study was performed. A total of 28 patients with metastatic colorectal cancer treated at Taipei Veterans General Hospital were enrolled. Oxaliplatin (85 mg/m, day 1 and 15), plus weekly bolus 5-fluorouracil (5-FU; 500 mg/m) and folinic acid (FA; 20 mg/m) on day 1, 8, and 15 were given every 28 days as first-line treatment. Chemotherapy-associated neurological toxicity and electrophysiological alterations, especially NCV, were assessed. Twenty patients showed a remarkably reduced NCV and the remainders were NCV-normal. After 6 cycles of treatments, a significant correlation was identified in NCV abnormalities and the severity of neurological symptoms (P=0.01), including 16 patients with a reduced NCV accompanied by severe (grade 3 or 4) neuropathy, and 6 patients with a normal NCV without developing severe neurological symptoms. However, there remained 2 patients with a normal NCV who developed severe (grade 3 or 4) neuropathies, and 4 patients who showed a remarkably reduced NCV without or with only mild neurological symptoms. We conclude that nerve conduction studies correlate well with the severity of neurological symptoms and may serve as a useful tool in objectively assessing the severity of oxaliplatin-induced peripheral neuropathy. The addition of a detailed electrophysiological examination to a precise physical examination may be effective in objectively assessing oxaliplatin-induced neuropathy.