Preventive Effect of Traditional Japanese Medicine on Neurotoxicity of FOLFOX for Metastatic Colorectal Cancer: A Multicenter Retrospective Study

• Published in: Anticancer research Vol. 32; no. 7; pp. 2545 - 2550
• Main Authors: HOSOKAWA, Ayumu, OGAWA, Kohei, FUKUOKA, Junya, SUGIYAMA, Toshiro, ANDO, Takayuki, SUZUKI, Nobuhiro, UEDA, Akira, KAJIURA, Shinya, KOBAYASHI, Yuka, TSUKIOKA, Yuji, HORIKAWA, Naoki, YABUSHITA, Kazuhisa
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01.07.2012
• Subjects: 5-Fluorouracil; Aged; Antibodies, Monoclonal, Humanized - administration & dosage; Antibodies, Monoclonal, Humanized - adverse effects; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bevacizumab; Biological and medical sciences; Chemotherapy; Colorectal cancer; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - pathology; Drug Combinations; Drugs, Chinese Herbal - therapeutic use; Female; Fluorouracil - administration & dosage; Fluorouracil - adverse effects; Folinic acid; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Leucovorin - administration & dosage; Leucovorin - adverse effects; Male; Medical sciences; Metastases; Middle Aged; Neoplasm Metastasis; Neurotoxicity; Neurotoxicity Syndromes - etiology; Neurotoxicity Syndromes - prevention & control; Organoplatinum Compounds - administration & dosage; Organoplatinum Compounds - adverse effects; oxaliplatin; Retrospective Studies; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Asia; Japan; Rectal disease; Multicenter study; Colorectal cancer; Malignant tumor; Metastasis; Retrospective; Colonic disease; Medicine; Prevention; Neurotoxicity; Cancerology; traditional Japanese medicine; goshajinkigan; Digestive diseases; Intestinal disease; Advanced stage; FOLFOX; Cancer; shakuyakukanzoto
• ISSN: 0250-7005; 1791-7530

A combination of 5-fluorouracil/folinic acid plus oxaliplatin (FOLFOX) is a standard regimen for the chemotherapy of metastatic colorectal cancer. The major dose-limiting toxic effect of oxaliplatin is neurotoxicity. The aim of this study was to evaluate the preventive effects of traditional Japanese medicines, goshajinkigan and shakuyakukanzoto on oxaliplatin-induced neurotoxicity with FOLFOX. Between July 2006 and November 2008, a total of 44 patients with metastatic colorectal cancer received modified FOLFOX6 or FOLFOX4, as first-line chemotherapy at three institutions. They concurrently received either goshajinkigan (group A, n=20) or shakuyakukanzoto (group B, n=24) for neurotoxicity reduction. The median number of treatment cycles and the median cumulative dose of oxaliplatin were 12 cycles (range, 4-19) and 898 mg/m(2) (range, 340-1255) in group A and 10.5 cycles (range, 6-20) and 845 mg/m(2) (range, 510-1480) in group B. Eighteen patients in group A and 24 in group B received oxaliplatin in a cumulative dose exceeding 500 mg/m(2). At a dose of 500 mg/m(2) oxaliplatin, grade 1-2 toxicity occurred in 10 patients of group A and in 7 of group B, but there was no grade 3 or higher toxicity in either group. The response rate of the 38 patients with measurable lesions was 50.0% (9/18) in group A and 65% (13/20) in group B. The administration of traditional Japanese medicine may reduce oxalipatin-induced neurotoxicity without negatively affecting tumor response in patients with colorectal cancer who undergo FOLFOX therapy.