Dorsal sural nerve conduction study in the assessment of oxaliplatin induced peripheral neuropathy

Dorsal Sural Nerve Conduction Study in the Assesment of Oxaliplatin Induced Peripheral Neuropathy Purposes: dorsal sural nerve (DSN) monitoring is a sensitive method for the detection of neuropathies. We performed a preliminary study to obtain evidence of its utility in the assessment of oxaliplatin-induced peripheral neuropathy. Patients: we evaluated 17 patients (5 women and 12 men, median age 60 years; range 42-76) affected by a gastrointestinal cancer, treated with an oxaliplatin-based regimen. Methods: patients were examined at the beginning of chemotherapy and after three months. At each time subjects underwent an antidromic conduction study of sural nerve (SN) and DSN. Results: before chemotherapy DSN Sensory Action Potential (SAP) median amplitude was 4,40 uV (range 1,9-9,9 uV) and median conduction velocity was 34,90 m/sec (27,2–43,5 m/sec); SN SAP median amplitude was 9,40 uV (5,4-25,7) and median conduction velocity was 50 m/sec (41-60,5); DSN SAP amplitude was pathological in three patients and SN SAP one in one patient. After three months of therapy DSN SAP median amplitude was 3,9 uV (1,5-6,6 uV) and median conduction velocity was 38,20 m/sec (29,9-42,6); SN SAP median amplitude was 9,30 uV (4,9-16,5) and median conduction velocity was 50,00 m/sec (40,4-62,1); DSN SAP amplitude was pathological in four and SN SAP in two patients. A decrease of 11,37% in DSN median SAP and of 1,06% in SN median SAP was seen after three months. Discussion: Oxaliplatin induced peripheral neuropathy determine a sensory distal neuronopathy in 20-30% of patients, associated to a decrease in SAP amplitude. In our series this decrease was detected more effectively in the DSN than in the SN even very early in the course of chemotherapy. Conclusion: the preliminary results obtained in this series suggest that DSN SAP might be used as an early marker of oxaliplatin-induced peripheral neurotoxicity. However, further indications could be obtained only prolonging the observation period and increasing the number of patients to be investigated prospectively.