PERIPHERAL NEUROPATHY INDUCED BY COMBINATION CHEMOTHERAPY OF DOCETAXEL AND CISPLATIN

Docetaxel, a new semisynthetic taxoid that has demonstrated promising activity as an antineoplastic agent, was administered in combination w ith cisplatin to 63 patients in a dose-escalating study. As both drugs were known to be potentially neurotoxic, peripheral neurotoxicity was prospectively assessed in detail. Neuropathy was evaluated by clinica l sum-score for signs and symptoms and by measurement of the vibration perception threshold (VPT). The severity of neuropathy was graded acc ording to the National Cancer Institute's 'Common Toxicity Criteria'. The docetaxel - cisplatin combination chemotherapy induced a predomina ntly sensory neuropathy in 29 (53%) out of 55 evaluable patients. At c umulative doses of both cisplatin and docetaxel above 200 mg m(-2), 26 (74%) out of 35 patients developed a neuropathy which was mild in 15, moderate in ten and severe in one patient. Significant correlations w ere present between both the cumulative dose of docetaxel and cisplati n and the post-treatment sum-score of neuropathy (P < 0.01) as well as the post-treatment VPT (P < 0.01). The neurotoxic effects of this com bination were more severe than either cisplatin or docetaxel as single agent at similar doses.