Neurophysiological manifestations of neuropathy induced by taxane and platinum chemotherapeutic agents

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Abstract

Background. Chemotherapy (CT)-induced peripheral neurotoxicity is one of the main dose-dependent side effects of many antitumor agents, including taxane and platinum agents. Symptoms of chemotherapy-induced peripheral neuropathy (CIPN) often persist after completion of treatment and affect the quality of life of patients who have undergone drug therapy for malignant tumors.

Objective. Identification of clinical and subclinical disorders in cancer patients with CIPN by studying the dynamics of neuromyographic parameters during antitumor treatment.

Material and methods. The study included 93 cancer patients with CIPN who underwent drug antitumor treatment. The mean age was 54.7±10.5 years. All patients underwent electroneuromyography (ENMG) using the Neuromag-EMG-micro electroneuromyograph (Neurosoft LLC, Russia) at the time of diagnosis of CIPN and 10 patients – 6 months after completion of chemotherapy.

Results. When evaluating the ENMG data during the initial examination of patients, a decrease in the amplitude of the sensory response of the median and sural nerves was recorded, which indicates a predominantly axonal-demyelinating lesion of the peripheral nerves. Repeated examination revealed worsening of nerve fiber conductivity, as evidenced by a decrease in the excitation propagation velocity (EPV) of the sensory response of the median and sural nerves, as well as a tendency to decrease in the EPV of the motor response of the median and tibial nerves.

Conclusion. Neurophysiological methods for assessing CIPN provide objective markers for the early diagnosis of toxicity, and the data obtained from patients help to assess the significance of symptoms in the context of the individual characteristics of each patient. However, given the small number of studies devoted to the study of the role of ENMG in patients with CIPN, further research is required.

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About the authors

S. V. Chubykina

Pirogov Russian National Research Medical University

Author for correspondence.
Email: svetasveta@bk.ru
ORCID iD: 0000-0001-5196-8992
Russian Federation, Moscow

M. Yu. Tatarinova

Pirogov Russian National Research Medical University

Email: svetasveta@bk.ru
ORCID iD: 0000-0002-2701-7326
Russian Federation, Moscow

G. G. Avakyan

Pirogov Russian National Research Medical University

Email: svetasveta@bk.ru
ORCID iD: 0000-0002-8985-8227
Russian Federation, Moscow

R. I. Knyazev

N.N. Blokhin National Medical Research Center of Oncology; Russian Medical Academy of Continuous Professional Education

Email: svetasveta@bk.ru
ORCID iD: 0000-0002-6341-0897
Russian Federation, Moscow; Moscow

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