オキサリプラチンによる急性末梢神経障害発症の危険因子の解析

抄録

Peripheral neuropathy (PN), a serious side effect of oxaliplatin (L-OHP), is classified as either acute PN or chronic PN. The incidence of acute PN is high, and cold hypersensitivity reduces the quality of life of patients. It is suggested that the frequency of acute PN can facilitate the evaluation of the onset and severity of chronic PN. Therefore, this study retrospectively analyzed the risk factors for the onset of acute PN.

Seventy-one subjects who received chemotherapy, including L-OHP, were included in the study. The subjects were assigned into two categories: groups in which the subjects experienced the onset of acute PN during the first course (n = 37); and groups in which the subjects did not develop acute PN during the first course (n = 34). For each item, including patient background, a comparison was made between the two groups. The initial dose of L-OHP was significantly higher in the subjects that experienced acute PN onset group during the first course (P < 0.001). In addition, in the highdose group such as SOX or CapeOX, the incidence of acute PN was significantly higher in the first course than in the low-dose group such as FOLFOX4/6 or FOLFIRINOX (P < 0.001).

As the initial dose of L-OHP is strongly suggested as a risk factor for acute PN, it was estimated that there was a high risk of developing acute PN in the first course of a high-dose regimen. Therefore, it is important to provide sufficient guidance on countermeasures at the initial administration.