The Effect of Diabetes on Oxaliplatin-Induced Peripheral Neuropathy

Chemotherapy-induced neurotoxicity is a significant source of morbidity for cancer patients. This retrospective study assessed for a relationship between preexisting diabetes and oxaliplatin-induced peripheral neuropathy (OXIPN) in patients being treated for colon cancer. Results showed diabetic patients developed OXIPN at a lower cumulative dose of oxaliplatin. The results may have implications for the personalization of chemotherapy for diabetics. Introduction: Chemotherapy-induced neurotoxicity is a significant source of morbidity for cancer patients. This study aimed to assess the :relationship between preexisting diabetes and clinically significant (National Cancer Institute Common Toxicity Criteria grades 2 and 3) OXIPN; between diabetes, and the cumulative dose at onset of OXIPN; and between other preexisting medical conditions and the development of OXIPN. Materials and Methods: We reviewed medical records of all patients with stage II-IV colon cancer treated in the Albert Einstein Cancer Center, Philadelphia, with oxaliplatin from 2005 to 2009. Exclusion criteria included preexisting neuropathy, previous neurotoxic chemotherapy exposure, and incomplete medical records. The NCI Common Toxicity Criteria was used to grade sensory neuropathy. Univariate analysis was used to estimate odds ratios and confidence limits for prevalence of OXIPN in patients with and without diabetes. The mean level and cumulative doses were compared using the t test. Results: Sixty-two patients met the study criteria; 23 oxaliplatin-treated patients were excluded. The crude incidence of any OXIPN was 65%. There was no relationship found between development of OXIPN and the presence of diabetes, smoking, hypertension, or statin use. However, the mean cumulative dose of oxaliplatin was significantly lower for patients with diabetes who developed neuropathy, compared with those without diabetes (388 vs. 610 mg/m(2); P = .021). Conclusion: Although the presence of diabetes did not appear to affect the severity of OXIPN, patients with diabetes developed OXIPN at a lower cumulative dose of oxaliplatin (P < .05). The results may have implications for treatment of patients with diabetes and colon cancer.