Paclitaxel does not cause central nervous adverse effects: A prospective vigilance-controlled EEG mapping study in ovarian cancer patients

Background: The objective of this study was to evaluate potential adverse e ffects of paclitaxel-containing chemotherapy on the central nervous system in women with ovarian cancer. Methods: Twenty-eight women with histologically confirmed epithelial ovaria n carcinoma and treated with combination chemotherapy consisting of paclita xel and carboplatin were entered into the study. Patients were tested with vigilance-controlled EEG before and after chemotherapy. Additionally, a bat tery of neuropsychologic tests before, after 3 cycles and at the end of the chemotherapy were performed. Results. Twenty of the 28 patients responded to chemotherapy (71%). Eleven patients (39%) developed peripheral neurotoxicity. A reduced vigilance in p atients with ovarian cancer prior to chemotherapy compared to healthy contr ols was observed (clearly demonstrated by an attenuated total power, a decr ease in fast alpha and slow beta activity, an increase in delta and theta a ctivity as well as a deceleration of the centroid of the total power spectr um). On the other hand, an improved vigilance in patients with ovarian canc er treated with paclitaxel/carboplatin was observed (demonstrated by an inc rease in total power and an increase in beta power, being more pronounced i n the right than in the left hemisphere, between pre- and post-treatment). The results of EEG mapping concurred with those of psychometric tests. The test results did not deteriorate during chemotherapy. A statistically signi ficant improvement in the alphabetical cross-out test from the first to the third measurement was observed, indicating an improvement in short-term at tention, concentration and the constancy of work during chemotherapy. Conclusions: Combination chemotherapy consisting of paclitaxel and carbopla tin does not cause encephalopathy, but a trend towards an improved vigilanc e and an improvement of short-term attention and concentration was observed in patients with ovarian cancer after chemotherapy.