578P - Adjuvant oxaliplatin dose and dose reductions are associated with severity of peripheral neuropathy among colorectal cancer survivors: Results from...

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer Agents
Complications/Toxicities of Treatment
Colon and Rectal Cancer
Biological Therapy
Presenter Tonneke Beijers
Citation Annals of Oncology (2014) 25 (suppl_4): iv167-iv209. 10.1093/annonc/mdu333
Authors T. Beijers1, F. Mols2, V.C. Tjan-Heijnen3, C.G. Faber4, L. van de Poll-Franse5, G. Vreugdenhil1
  • 1Internal Medicine, Medical Oncology, Maxima Medisch Centrum -Veldhoven, 5500 MB - Veldhoven/NL
  • 2Department Of Medical And Clinical Psychology, CoRPS - Center of Research on Psychology in Somatic diseases, 5037AB - Tilburg/NL
  • 3Department Of Medical Oncology, Grow-school For Oncology And Developmental Biology, Maastricht University Medical Centre+ (MUMC+), Maastricht/NL
  • 4Neurology, Maastricht University Medical Center+, Maastricht/NL
  • 5Eindhoven Cancer Registry, Comprehensive Cancer Centre Netherlands (CCCN), Eindhoven/NL



Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting side effect of oxaliplatin which can negatively influence quality of life. We aimed to study the influence of cumulative dose, dose schedule and dose reductions of adjuvant oxaliplatin on long-term severity and prevalence of CIPN among colorectal cancer (CRC) survivors.


A total of 188 patients, diagnosed with CRC between 2000 and 2009 who underwent adjuvant treatment with oxaliplatin, were included. Patients were identified by the Eindhoven Cancer Registry. All patients completed the EORTC QLQ-CIPN20 2-11 years after diagnosis. Data on oxaliplatin administration and acute neuropathy during treatment were extracted from the medical files.


Oxaliplatin was given for a median 6 cycles (range 1-12) at a mean cumulative dose of 680 mg/m2 (SD 265). Patients who received cumulative oxaliplatin dose of ≥842 mg/m2 had a significantly worse EORTC QLQ-CIPN20 sensory score compared to those who received a low cumulative dose of <421 mg/m2 (mean 19 vs. 8; P = 0.026). High dose patients more often reported tingling toes/feet (14% vs. 1% respectively; P = 0.008). Patients who received a dose reduction after the 6th cycle of oxaliplatin reported more severe long-term neuropathy symptoms than patients who received a dose reduction earlier. Dose intensity and time delay did not influence the occurrence of long-term neuropathy. Patients who received a dose reduction because of neuropathy (N = 51) reported a significantly worse sensory score at very similar cumulative doses, than those who did not receive a dose reduction because of neuropathy (N = 83) (mean 20 vs. 15; P = 0.01).


Cumulative dose of oxaliplatin is associated with long-term CIPN in CRC survivors. The risk of developing long-term CIPN could only be reduced by decreasing the cumulative dose of oxaliplatin early in the treatment period. Future studies should focus on identifying patients who are at risk of developing CIPN.


All authors have declared no conflicts of interest.