Postoperative Exacerbation of Oxaliplatin-induced Neurotoxicity in Gastrointestinal Cancers: A Case Series

Dose dependent slurred speech and laryngopharyngeal dysesthesia due to oxaliplatin

INTRODUCTION

Oxaliplatin is a platinum containing alkylating agent commonly used in the management of colorectal cancers. The most common dose-limiting toxicity of oxaliplatin is peripheral neuropathy, which can be severe enough to cause treatment discontinuation. We present a case of dysarthria and laryngopharyngeal dysesthesia (LPD) that developed during the first dose of oxaliplatin, which showed dose-dependent reduction in severity in subsequent cycles.

CASE REPORT

A 52-year-old female patient with adenocarcinoma of rectum (pT4N2M0) was prescribed oxaliplatin (130 mg/m²) and capecitabine(2000mg/m²). She developed heaviness in the tongue, slurred speech, jaw pain, perioral paresthesia within 30 min after the end of 3 h infusion of oxaliplatin in the first cycle. The symptoms subsided without any sequelae in two days. However, in the subsequent cycles as the dose of the oxaliplatin was reduced, similar symptoms reappeared but were of reduced in severity. No dysesthesia symptoms were observed in the 4th cycle when the oxaliplatin was administered at 85 mg/m².

MANAGEMENT AND OUTCOME

As and when the patient developed symptoms - slurred speech, jaw pain during the first three cycles, she was managed with inj. Hydrocortisone (100 mg i.v.) and one ampoule of pheniramine (45 mg i.v.).

DISCUSSION

Occurrence of laryngopharyngeal dysesthesia due to oxaliplatin does not warrant drug withdrawal, dose titration can be helpful, thereby preventing the drug withdrawal for the patient management.

Meta-Analysis on the Improvement of Symptoms and Prognosis of Gastrointestinal Tumors Based on Medical Care and Exercise Intervention

Gastric cancer is a malignant tumor that originates from the epithelium of the gastric mucosa. It is the result of a combination of multiple factors, but the current research has not yet clarified its pathogenesis, so further research and exploration are needed. This article is mainly based on the meta-analysis of the improvement of gastrointestinal tumor-related symptoms and prognosis based on medical care and exercise intervention. The control group followed routine care after enrollment. In addition to routine care, patients in the intervention group exercised through assessment, formulation of exercise prescriptions, implementation of supervision, and adjustment. By viewing the subjects' physical examination reports, determine their blood routine, urine routine, blood lipids, blood sugar, liver and kidney function, and electrocardiogram examination. In this experiment, dual-contrast ultrasound in each T staging was greater than 0.8, indicating that the diagnostic method is very accurate in the preoperative diagnosis of gastric cancer T staging. The results show that exercise intervention can improve the pain of patients with gastrointestinal tumors after chemotherapy, relieve cancer-induced fatigue, and improve the quality of life.

Impact of Fluoropyrimidine and Oxaliplatin-based Chemoradiotherapy in Patients With Locally Advanced Rectal Cancer

BACKGROUND/AIM

To evaluate the benefits of the addition of oxaliplatin (OX) to fluoropyrimidine (FP)-based neoadjuvant chemoradiotherapy (CRT) for patients with locally advanced rectal cancers (LARCs).

PATIENTS AND METHODS

We performed retrospective analyses comparing the pathological complete response (pCR) rate, overall survival (OS), recurrence-free survival (RFS), and local recurrence-free survival (LRFS) between FP-based and FP+OX-based CRT groups and for patients who had completed the CRT.

RESULTS

One hundred patients were included in the analyses: the pCR rate, OS, RFS, and LRFS were similar between these groups. The FP+OX group showed significantly more frequent incompleteness of the CRT compared to the FP group (p=0.049). Among the patients who had completed the CRT, the FP+OX group demonstrated significantly improved LRFS compared to the FP group (p=0.048).

CONCLUSION

The addition of OX to an FP regimen in neoadjuvant CRT for LARC may reduce local recurrence in patients who have achieved good compliance to CRT.