Journal Article

DKFZ-2026-00396

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Oxaliplatin-induced neuropathy after total neoadjuvant therapy for rectal cancer: Dose-response relationship and impact on quality of life.

Wurschi, G. W. ; Hinz, A. ; Schneider, M. ; Becker, J.-N. ; Frerker, B. ; Vorbach, S. M. ; Ehret, F.DKFZ* ; Diefenhardt, M. ; Schunn, F. ; von Gruben, M.-E. ; Büttner, M.DKFZ* ; Hoffmann, E.DKFZ* ; Rühle, A.DKFZ* ; Beier, J. ; Ferdinandus, S. ; Trommer, M. ; Sahin, E. C. ; Hlouschek, J. ; Aninditha, K. ; von Ohlen, D. S. ; Kaufmann, J. ; Depardon, A. ; Ha, H. M. ; Kessler, C. ; Cieslak, A. ; Trommer, S. ; Fabian, A. ; Rißner, F. ; Römer, M. ; Pietschmann, K.

2026
Wiley-Liss Bognor Regis

Abstract: Oxaliplatin-based regimens are increasingly used in total neoadjuvant therapy (TNT) for locally advanced rectal cancer, frequently causing dose-limiting chemotherapy-induced peripheral neuropathy (CIPN), whose extent and impact on health-related quality of life (HrQoL) remain insufficiently characterized. The optimal duration and intensity of chemotherapy within TNT for tumor response and toxicity remain unclear. This retrospective multicenter study (DRKS00033000) assessed the dose-response relationship of CIPN with cumulative oxaliplatin dose (cOXAd) and its impact on HrQoL. A total of 227 patients (164 men) with a median age of 63 (Q1-Q3: 54-68) years, who underwent oxaliplatin-based TNT between 2015 and 2024, were analyzed. HrQoL was assessed cross-sectionally during follow-up using the EORTC QLQ-C30 and QLQ-CIPN20 questionnaires. Multivariable logistic regression was applied to evaluate the relationship between cOXAd and CIPN grade ≥2, and known-group comparisons examined differences in HrQoL scores. At follow-up, 61 patients (26.9%) experienced CIPN grade ≥2 after a median cOXAd of 758.8 mg/m2. Higher cOXAd was associated with an increased likelihood of CIPN grade ≥2 (adjusted OR 1.004, 95% CI: 1.002-1.007), corresponding to a 7.8% higher probability per additional FOLFOX cycle (+85 mg/m2 cOXAd). Patients with CIPN grade ≥2 reported lower mean QLQ-C30 Global Health Scores and Summary Scores (-13.0 and -12.4 points; Cohen's d = -0.59 and -0.68) and higher QLQ-CIPN20 Summary Scores (+23.9 points; Cohen's d = 1.65) compared to those without CIPN. These findings indicate that CIPN is a common dose-dependent toxicity of oxaliplatin-based TNT, associated with considerably reduced HrQoL and markedly increased neuropathy-related symptom burden at follow-up.

Keyword(s): CIPN ; oxaliplatin ; polyneuropathy ; rectal cancer ; total neoadjuvant therapy

Note: #DKTKZFB26# / epub

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Berlin (BE01)
2. DKTK Koordinierungsstelle Tübingen (TU01)
3. DKTK Koordinierungsstelle Freiburg (FR01)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2026

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; DEAL Wiley ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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