Cancer chemotherapy and pharmacology
Protective effect of N-acetylcysteine on oxaliplatin-induced peripheral neuropathy in colorectal cancer: a randomized controlled trial
By Hegazy ZK, Tawfik SK and Elmashad NM.
Abstract
Purpose
Oxaliplatin-induced peripheral neuropathy (OIPN) is a dose-limiting adverse effect of FOLFOX chemotherapy in colorectal cancer (CRC) patients. We aimed to evaluate the protective effect of N-acetylcysteine (NAC) against OIPN. Additionally, we investigated its mechanistic effects on serum biomarkers including total antioxidant capacity (TAC), interleukin-6 (IL-6), and neurotensin.
Methods
Forty-six patients with stage III or high-risk stage II CRC receiving adjuvant modified FOLFOX-6 chemotherapy were randomized in a 1:1 ratio to receive either oral NAC 1200 mg (effervescent tablets or granules) or placebo one hour before each oxaliplatin infusion for four cycles. Serum levels of TAC, IL-6, and neurotensin were measured before and after treatment. Neuropathy was assessed using the FACT/GOG-NTX-12 and NCI-CTCAE scales, and pain was estimated by using the Brief Pain Inventory-Short Form.