Prevention of oxaliplatin-related neurotoxicity by ω-3 PUFAs A double-blind randomized study of patients receiving oxaliplatin combined with capecitabine for colon cancer

Background: Peripheral neurotoxicity (PN) is a frequent side effect of oxaliplatin treatment, and also is its dose-limiting toxicity. Studies have confirmed that omega-3 polyunsaturated fatty acids (omega-3 PUFAs) had a neuroprotective effect. However, the efficacy of omega-3 PUFAs on the prevention of oxaliplatin-related neurotoxicity remains unclear. We assessed the effect of omega-3 PUFAs on the neurotoxicity in colon cancer patients treated by oxaliplatin combined with capecitabine. Methods: In a randomized, double-blind, placebo-controlled study, 179 patients with colon cancer receiving oxaliplatin combined with capecitabine were recruited, and randomly assigned to take omega-3 PUFAs, 640 mg t.i.d during chemotherapy and 1 month after the end of the treatment or placebo. All patients were treated with chemotherapy for 6 treatment cycles. The incidence and severity of PN were evaluated, and the nerve conduction was measured before the onset of chemotherapy and 1 month after treatment. In addition, the quality of life was also accessed using Chinese version of European organization for research and treatment of cancer quality of life questionnaire. Results: The incidence of PN in the omega-3 PUFAs group and placebo group was 52.22% and 69.66%, respectively (P = .017). In addition, there was a significant difference in the severity of PN between the 2 groups (P = .017). In terms of motor and sensory nerve conduction, the sensory action potentials amplitude of sural nerve in the omega-3 PUFAs group and placebo group after chemotherapy treatment were (15.01 +/- 3.14) and (13.00 +/- 3.63) mu V respectively, suggesting there was a significant difference in the 2 groups (P = .000). In addition, the mean score of the global health-status/quality of life was obviously higher in the omega-3 PUFAs group than that in the placebo group. Conclusion: omega-3 PUFAs seem to reduce the incidence and severity of oxaliplatin-related neurotoxicity, and improve the quality of patients' life, indicating it is expected to be a potential drug for the treatment of oxaliplatin-related neurotoxicity.