The most important cytotoxic drugs for the treatment of ovarian cancer, pla
tinum compounds and paclitaxel, are known to induce neurotoxicity, which is
dose limiting when higher paclitaxel doses are used or platinum-pretreated
patients are treated. The absolute dose of paclitaxel per course has been
demonstrated to be an important risk factor for the development of neurotox
icity. The role of cumulative dose, treatment duration and infusion schedul
e as additional risk factors are still in debate, and are therefore evaluat
ed in this study. This study evaluates paclitaxel induced neurotoxicity in
38 patients, most of whom had already received platinum treatment, receivin
g either 135 or 175 mg/m(2) as 3-h or 24-h infusion. Patients were compared
with an age-matched control group. A detailed questionnaire and neurophysi
ological measurements including vibration perception threshold were used. O
verall, the majority of patients (76%) developed some degree of neurotoxici
ty, but symptoms were usually mild or moderate with no grade 3/4 neurotoxic
ity observed. Age has been demonstrated to be an important risk factor for
the development of neurotoxicity. Furthermore, the higher. dose per course
showed a significant impact on neurotoxicity, while the different infusion
schedules were of minor importance. Vibration threshold perception, 2-point
discrimination, a walking-the-line test, and reports of paresthesias were
shown to be the most sensitive and useful parameters for neurotoxicity eval
uation, Neurotoxicity is a common adverse event during paclitaxel chemother
apy in platinum-pretreated patients. A clinically useful test panel compose
d of a detailed history and the above three easily performed neurophysiolog
ical evaluations should be incorporated into future studies evaluating new
drugs, treatment modifications, new combinations, and potential modulators
of chemotherapy-induced neurotoxicity.