Residual neurotoxicity in ovarian cancer patients in clinical remission after first-line chemotherapy with carboplatin and paclitaxel: The Multicenter Italian Trial in Ovarian cancer MITO-4 retrospective studyReport as inadecuate




Residual neurotoxicity in ovarian cancer patients in clinical remission after first-line chemotherapy with carboplatin and paclitaxel: The Multicenter Italian Trial in Ovarian cancer MITO-4 retrospective study - Download this document for free, or read online. Document in PDF available to download.

BMC Cancer

, 6:5

First Online: 07 January 2006Received: 13 September 2005Accepted: 07 January 2006DOI: 10.1186-1471-2407-6-5

Cite this article as: Pignata, S., De Placido, S., Biamonte, R. et al. BMC Cancer 2006 6: 5. doi:10.1186-1471-2407-6-5

Abstract

BackgroundCarboplatin-paclitaxel is the chemotherapy of choice for advanced ovarian cancer, both in first line and in platinum-sensitive recurrence. Although a significant proportion of patients have some neurotoxicity during treatment, the long-term outcome of chemotherapy-induced neuropathy has been scantly studied. We retrospectively assessed the prevalence of residual neuropathy in a cohort of patients in clinical remission after first-line carboplatin-paclitaxel for advanced ovarian cancer.

Methods120 patients have been included in this study 101 participating in a multicentre phase III trial evaluating the efficacy of consolidation treatment with topotecan, and 19 treated at the National Cancer Institute of Naples after the end of the trial. All patients received carboplatin AUC 5 plus paclitaxel 175 mg-m every 3 weeks for 6 cycles, completing treatment between 1998 and 2003. Data were collected between May and September 2004. Residual sensory and motor neurotoxicity were coded according to the National Cancer Institute – Common Toxicity Criteria.

Results55 patients 46% did not experience any grade of neurological toxicity during chemotherapy and of these none had signs of neuropathy during follow-up. The other 65 patients 54% had chemotherapy-induced neurotoxicity during treatment and follow-up data are available for 60 of them. Fourteen out of 60 patients 23% referred residual neuropathy at the most recent follow-up visit, after a median follow up of 18 months range, 7–58 months: 12 patients had grade 1 and 2 patients grade 2 peripheral sensory neuropathy; 3 patients also had grade 1 motor neuropathy. The remaining 46-60 patients 77% had no residual neuropathy at the moment of interview: recovery from neurotoxicity had occurred in the first 2 months after the end of chemotherapy in 22 37%, between 2 and 6 months in 15 25%, or after more than 6 months in 9 patients 15%. Considering all 120 treated patients, there was a 15% probability of persistent neurological toxicity 6 months after the end of chemotherapy.

ConclusionA significant proportion of patients with advanced ovarian cancer treated with first-line carboplatin-paclitaxel suffer long-term residual neuropathy. This issue should be carefully taken into account before considering re-treatment with the same agents in sensitive recurrent disease.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-6-5 contains supplementary material, which is available to authorized users.

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