Clinical Observation Of Prevention Of Oxaliplatin-Related Neurotoxicity By External Bath Of "Wen Jing Huo Xue Decoction"

ObjectiveTo observe the efficacy of "Wen Jing Huo Xue Decoctio" washing in prevention of neurotoxicity induced by oxaliplatin, containing the observation of symptoms of peripheral neuropathy, the observation of grading of peripheral neuropathy and the medication safety. Meanwhile, to provide theoretical and practical reference for traditional Chinese medicine in the standardized treatment of the peripheral nerve toxicity caused by chemotherapeutics.MethodAccording to the inclusion criteria and exclusion criteria, collect 50 cases that had a definitive diagnosis of colorectal cancer and preparing to receive the chemotherapy regimen XELOXA. The cases were randomly divided into treatment group and control group. The treatment group received traditional Chinese medicine(Wen Jing Huo Xue Decoction) and washing from the first day of chemotherapy to the seventh day,7 days as a recycle, washing two consecutive cycles. The specific process is:soaking the feet and hands, feet after hands, each 15min, totally 30min qd, with the water temperature of about 35℃-40℃.Control group received no bath. To observe and record the symptoms of peripheral neurotoxicity weekly,until one week after the finish of the second chemotherapy periodjust before the third chemotherapy period began. The general observation time was 6 weeks, and to evaluate the grade of peripheral neurotoxicity every 3 weeks. To analyze and compare the incidence of peripheral neurotoxicity and classification of peripheral neurotoxicity between treatment group and control group. In the meantime, also to evaluate the security of TCM bath in this study.ResultsThe difference of baseline characteristics like age、gender、state of illness between two groups had no statistical significance (P>0.05) Treatment results are as follows:1. By the third week of observation, the incidence of grade zero neurotoxicity in treatment group was 0, incidence of grade 1-2 neurotoxicity was 4.0%, incidence of grade 3-4 neurotoxicity was 0, compared with 80.0%,16.0%,4.0% in control group, there was no statistical significance (P >0.05). The total incidence of neurotoxicity in treatment group was 4.0%, while it was 20.0% in the other group, and the differences were not statistically significant. When it comes to the reasons, the main consideration is that there has correlation between the occurrence of oxaliplatin-related neurotoxicity and its cumulative dose. Patients Included in the study mostly had no apparent neurotoxicity temporarily after the first chemotherapy course, also the intervening measure could not reflect the differences temporarily.2, By the sixth week of observation, the incidence of grade zero neurotoxicity in treatment group was 76.0%, incidence of grade 1-2 neurotoxicity was 20.0%, incidence of grade 3-4 neurotoxicity was 4.0%, compared with 40.0%,44.0%,16.0% in control group, differences were statistically significant (P<0.05).The total incidence of neurotoxicity in treatment group was 4.0%, while it was 20.0% in the other group, and the differences were statistically significant (P<0.05)3、Until the end of the observation, all patients included did not see related skin toxicity, and there was no adverse event happen.Conelusion1、Wen Jing Huo Xue Decoction" have certain preventive effects for the peripheral neuropathy caused by oxaliplatin. Considering that the occurrence of oxaliplatin-related neurotoxicity is related with its cumulative dose, so, in the early days of chemotherapy, when cumulative dose haven’t reach a certain extent, intervention group and control group can not reflect the differences temporarily.2、Wen Jing Huo Xue Decoction" has no obvious skin toxicity to wash outside and shows good safety.