CORTICOSTEROID CO-MEDICATION DOES NOT REDUCE THE INCIDENCE AND SEVERITY OF NEUROTOXICITY INDUCED BY DOCETAXEL

Docetaxel is a new antimicrotubule agent that induces a predominantly sensory neuropathy that is mild in most patients. This prospective stu dy was performed to determine if corticosteroid co-medication reduces the incidence and severity of docetaxel-induced neuropathy. Two groups of patients treated with docetaxel in subsequent cohorts were prospec tively analyzed for neurotoxicity. Group A consisted of 38 patients wi th a variety of solid tumors, who were treated in studies before corti costeroid co-medication was recommended, while 49 female patients in g roup a with metastatic breast cancer were treated after co-medication with corticosteroids was introduced as a routine. Neuropathy was evalu ated by a clinical sum-score for symptoms and signs, and by measuremen t of the vibration perception threshold (VPT). The severity of neuropa thy was graded according to NCI Common Toxicity Criteria. In 42% of pa tients of group A and in 65% of patients of group a a mainly mild neur opathy was documented. There was no statistically significant differen ce in neurotoxicity between group A and a, The cumulative dose of doce taxel showed a significant correlation with post-treatment scores of V PT, sensory sum-score, grade of paresthesias, and grade of neurosensor y and neuromotor toxicity, Corticosteroid co-medication does not reduc e the development of docetaxel-related neuropathy. [(C) 1998 Lippincot t Williams & Wilkins.].