Survival difference associated with controlled-release oxycodone analgesic therapy for oxaliplatin-induced peripheral neuropathy in advanced colorectal cancer patients

Oxaliplatin is a platinum-based cytotoxic chemotherapeutic agent, and is usually used in combination; as part of the FOLFOX regimen, to treat advanced colorectal cancer (CRC) patients. However, oxaliplatin produces significant chemotherapy-induced peripheral neuropathy (CIPN), a potential dose-limiting side effect of treatment. Preventive and therapeutic protocol for oxaliplatin-induced peripheral neuropathy (OIPN) has not yet been established. Previously, we reported that controlled-release oxycodone (CR oxycodone) attenuated the pain of OIPN and extended FOLFOX therapy in advanced CRC patients. We further investigated the efficacy of CR oxycodone for OIPN and its association with patients’ survival time. This was a retrospective analysis of advanced CRC patients. A total of 64 patients with stage III or IV CRC were included in this study. All patients underwent surgery to extirpate the primary CRC and received curative-intent FOLFOX chemotherapy. Patients who were administered CR oxycodone during the FOLFOX therapy period were defined as the OXY group (29 cases), and those who did not receive CR oxycodone treatment were defined as the non-OXY group (35 cases). Survival time was calculated using the Kaplan-Meier method to determine differences between patients in the OXY and the non-OXY groups. Patients in the OXY group had relatively longer survival than those in the non-OXY group (median survival, 58 months vs. 36 months; P=0.06). Early administration of CR oxycodone for OIPN might be relatively effective for better patient compliance with FOLFOX chemotherapy, a better QOL, and longer survival in patients with advanced CRC. *Correspondence to: Makoto Nagashima, Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura 285-8741, Japan, Tel: +81-43-462-8811, Fax: +81-43-463-1456, E-mail: nagashima@sakura.med. toho-u.ac.jp