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首页> 外文期刊>European journal of neurology: the official journal of the European Federation of Neurological Societies >Ultrasound assessment of oxaliplatin-induced neuropathy and correlations with neurophysiologic findings
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Ultrasound assessment of oxaliplatin-induced neuropathy and correlations with neurophysiologic findings

机译：奥沙利铂引起的神经病变的超声评估及其与神经生理学发现的相关性

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Background and purpose: Chemotherapy-induced peripheral neuropathy is a major adverse effect of oxaliplatin (OXL) treatment. Whereas neurophysiologic study is commonly used to assess the occurrence and severity of polyneuropathies, ultrasound (US) analysis of the peripheral nerves, an emerging technique in the study of peripheral nerve diseases, has never been used in chemotherapy-induced peripheral neuropathy. Patients and methods: Fifteen patients (four women; 11 men; mean age, 60.1 ± 10.6 years; median, 62; range, 37-75) with colorectal cancer treated with OXL-based treatment have been clinically and neurophysiologically evaluated before and after OXL therapy. At the end of chemotherapy, all patients underwent also nerve US study at four limbs, and the findings correlated with clinical and neurophysiologic measures. Results: Clinical and neurophysiological evaluation showed that 13 of 15 (86.7%) patients developed sensory axonal neuropathy, 10 of whom severe (two or more sensory nerve action potential amplitude absent and the other amplitudes decreased of ≥50%). Nerve US did not reveal decreased cross-sectional area (CSA), a reported finding in axonal neuropathies. Instead increased CSA at entrapment sites (median nerve at wrist and ulnar nerve at elbow) was found in 09/15 (60%) of patients. Discussion: Sensory axonal neuropathy is a very common complication of OXL therapy, affecting almost 90% of patients. US findings of enlargement of median and ulnar nerves, mostly at entrapment sites, in patients with no history or symptoms of neuropathies at recruitment, and no neurophysiologic evidence of entrapment, may be expression of increased, OXL-induced, nerve susceptibility to mechanical damage. An ongoing prospective study will help clarify these findings.
机译：背景与目的：化疗引起的周围神经病变是奥沙利铂（OXL）治疗的主要不良反应。尽管神经生理学研究通常用于评估多发性神经病的发生和严重程度，但周围神经的超声（US）分析是研究周围神经疾病的新兴技术，但从未用于化学疗法诱发的周围神经病。患者和方法：在以OXL为基础的治疗前后，对15例患有结直肠癌的患者（4名女性; 11名男性;平均年龄60.1±10.6岁;中位年龄62;范围37-75）进行了临床和神经生理学评估治疗。化疗结束后，所有患者均接受了四肢神经US研究，其发现与临床和神经生理学指标相关。结果：临床和神经生理学评估显示，在15例患者中有13例（86.7％）出现了感觉轴突神经病，其中10例严重（没有两个或多个感觉神经动作电位幅度，其他幅度降低了≥50％）。据报道，在轴突神经病中，神经US并未显示出横截面积（CSA）的减少。取而代之的是，在09/15（60％）的患者中发现截留部位（腕部中部神经和肘部尺神经）的CSA升高。讨论：感觉轴突神经病是OXL治疗的一种非常常见的并发症，影响了近90％的患者。在美国，发现无募集病史或症状且无神经生理学证据的患者中位神经和尺神经增大，主要发生在神经压迫部位，可能是由OXL引起的对机械损伤的神经易感性增加。正在进行的前瞻性研究将有助于澄清这些发现。

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