Prevalence and characteristics of neuropathy in carcinoma colon patients on FOLFOX4 therapy

Prevalence and characteristics of neuropathy in carcinoma colon

Abstract

Background: Colorectal cancer (CRC) is the third most common cancer in men and the second in women worldwide. The burden of colorectal cancer has risen rapidly in economically developed asian countries.Radical surgical resection is the main treatment of colorectal carcinoma. FOLFOX 4 is best first line treatment regime for colorectal carcinoma. Peripheral neuropathy is the important side effect of FOLFOX 4 regime.The aim of this study is to study the prevalence and characteristics of neuropathy in carcinoma colon patients on FOLFOX 4 therapy. Subjects and Methods:60 patients of colorectal carcinoma on FOLFOX 4 therapy were included in the study. Out of 60, 46 patients agreed for participation in the study after taking informed consent.All patients were questioned about symptoms General physical examination was carried out along with detailed neurological examination. Neurological examination also included modified total neuropathy score.  Analysis was done on basis of symptoms, signs and modified total neuropathy score. Nerve conduction velocity study (total neuropathy score) was used only if the patient was willing for the test.  Analysis was done at start of FOLFOX 4 chemotherapy, after 6 cycles and 12 cycles respectfully.Results: Among the 46 cases 25 were males (54.34%) and 21 were females (45.65%). Of a total of forty six patients peripheral neuropathy was diagnosed in twenty six patients based on modified neuropathy score hence the prevalence of neuropathy was found to be 56.52%. Amongst motor symptoms, symptoms related to hand dexterity were commonly observed (n=4, 15.38%) followed by foot walking (n=2, 7.68%). Conclusion:Neuropathy was more common in females. Sensory neuropathy was more than mixed and motor neuropathy.Tingling was most common. Most patients had mild grade of neuropathy.