Table of Contents
Chemotherapy Research and Practice
Volume 2013, Article ID 379870, 7 pages
Research Article

Neurological Adverse Effects in Patients of Advanced Colorectal Carcinoma Treated with Different Schedules of FOLFOX

1Department of Pharmacology, University of Karachi, Karachi 75270, Pakistan
2Department of Pharmacy, Jinnah University for Women, Karachi 74600, Pakistan
3Ziauddin College of Pharmacy, Ziauddin University, 4/B, Block 6, Shahrah-e-Ghalib, Clifton, Karachi 75600, Pakistan
4Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN), Karachi 75330, Pakistan

Received 22 May 2013; Revised 25 August 2013; Accepted 26 August 2013

Academic Editor: Vassilios A. Georgoulias

Copyright © 2013 Nusrat Bano et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The study is designed to assess the frequency and severity of few dose limiting neurological adverse effects of four different schedules of FOLFOX. Patients with histologically confirmed advanced colorectal carcinoma (CRC) were included in the study. Toxicity was graded according to CTC v 2.0. The frequency of grade 3 and 4 adverse effects was comparatively assessed in each treatment arm. The difference in the pattern of toxicity between the treatment schedule was evaluated. The most frequent adverse symptom of neurological adverse effect was grade 1 paresthesia in the patients treated with FOLFOX4 schedule. Grade 4 peripheral neuropathy was reported in few patients of FOLFOX7 treatment arm. Frequency and onset of neurological adverse effects like paresthesia, dizziness, and hypoesthesia were significantly different ( ), whereas frequency and onset of peripheral neuropathy were highly significant ( ) in each treatment arm of FOLFOX. Peripheral neuropathy was associated with electrolyte imbalance and diabetes in few patients. Frequency of symptoms, for example, paresthesia, is associated with increased number of recurrent exposure to oxaliplatin (increased number of cycles) even at low doses (85 mg/m2), whereas severity of symptoms, for example, peripheral neuropathy, is associated with higher dose (130 mg/m2) after few treatment cycles.