Glutamine as a neuroprotective agent in high-dose paclitaxel-induced peripheral neuropathy: A clinical and electrophysiologic study Journal Article
| Authors: | Stubblefield, M. D.; Vahdat, L. T.; Balmaceda, C. M.; Troxel, A. B.; Hesdorffer, C. S.; Gooch, C. L. |
| Article Title: | Glutamine as a neuroprotective agent in high-dose paclitaxel-induced peripheral neuropathy: A clinical and electrophysiologic study |
| Abstract: | Aims: The appearance of peripheral neuropathy is the dose-limiting toxicity in many chemotherapy protocols, and glutamine has been proposed as a potentially neuroprotective agent in patients receiving paclitaxel. Materials and methods: In this non-randomised study, we assessed neurologic signs and symptoms, and changes in nerve-conduction studies in 46 consecutive patients given high-dose paclitaxel either with (n = 17) or without (n = 29) glutamine. Neurological assessments and electrodiagnostic studies were carried out at baseline and at least 2 weeks (median 32 days) after treatment. Results: Patients who received glutamine developed significantly less weakness (P = 0.02), less loss of vibratory sensation (P = 0.04) and less toe numbness (P = 0.004) than controls. The per cent change in the compound motor action potential (CMAP) and sensory nerve action potential (SNAP) amplitudes after paclitaxel treatment was lower in the glutamine group, but this finding was not statistically significant in these small groups. Conclusions: In this study, serial neurologic assessment of patient symptoms and signs seemed to be a better indicator of a possible glutamine effect than sensory- or motor-nerve-conduction studies. Prospective randomised trials are needed to clarify the effect of glutamine on paclitaxel and other types of chemotherapy-induced neuropathy. © 2005 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved. |
| Keywords: | clinical article; controlled study; clinical trial; paresthesia; paclitaxel; chemotherapy; drug megadose; carboplatin; controlled clinical trial; breast cancer; neuropathy; antineoplastic combined chemotherapy protocols; peripheral neuropathy; antineoplastic agents, phytogenic; cyclophosphamide; melphalan; stem cell transplantation; breast neoplasms; thiotepa; statistical significance; stem cell mobilization; muscle weakness; electromyography; sensory dysfunction; mesna; administration, oral; granulocyte colony stimulating factor; granulocyte colony-stimulating factor; amplitude modulation; electrophysiology; glutamine; drug induced disease; peripheral nervous system diseases; nerve potential; neurologic examination; neuroprotection; neuroprotective agents; action potentials; electrodiagnosis; neural conduction; nerve conduction; vibration sense |
| Journal Title: | Clinical Oncology |
| Volume: | 17 |
| Issue: | 4 |
| ISSN: | 0936-6555 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2005-06-01 |
| Start Page: | 271 |
| End Page: | 276 |
| Language: | English |
| DOI: | 10.1016/j.clon.2004.11.014 |
| PUBMED: | 15997923 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 42" - "Export Date: 24 October 2012" - "CODEN: CLIOE" - "Source: Scopus" |
