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000309947 1001_ $$00000-0002-8751-9862$$aWurschi, Georg W$$b0
000309947 245__ $$aOxaliplatin-induced neuropathy after total neoadjuvant therapy for rectal cancer: Dose-response relationship and impact on quality of life.
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000309947 520__ $$aOxaliplatin-based regimens are increasingly used in total neoadjuvant therapy (TNT) for locally advanced rectal cancer, frequently causing dose-limiting chemotherapy-induced peripheral neuropathy (CIPN), whose extent and impact on health-related quality of life (HrQoL) remain insufficiently characterized. The optimal duration and intensity of chemotherapy within TNT for tumor response and toxicity remain unclear. This retrospective multicenter study (DRKS00033000) assessed the dose-response relationship of CIPN with cumulative oxaliplatin dose (cOXAd) and its impact on HrQoL. A total of 227 patients (164 men) with a median age of 63 (Q1-Q3: 54-68) years, who underwent oxaliplatin-based TNT between 2015 and 2024, were analyzed. HrQoL was assessed cross-sectionally during follow-up using the EORTC QLQ-C30 and QLQ-CIPN20 questionnaires. Multivariable logistic regression was applied to evaluate the relationship between cOXAd and CIPN grade ≥2, and known-group comparisons examined differences in HrQoL scores. At follow-up, 61 patients (26.9%) experienced CIPN grade ≥2 after a median cOXAd of 758.8 mg/m2. Higher cOXAd was associated with an increased likelihood of CIPN grade ≥2 (adjusted OR 1.004, 95% CI: 1.002-1.007), corresponding to a 7.8% higher probability per additional FOLFOX cycle (+85 mg/m2 cOXAd). Patients with CIPN grade ≥2 reported lower mean QLQ-C30 Global Health Scores and Summary Scores (-13.0 and -12.4 points; Cohen's d = -0.59 and -0.68) and higher QLQ-CIPN20 Summary Scores (+23.9 points; Cohen's d = 1.65) compared to those without CIPN. These findings indicate that CIPN is a common dose-dependent toxicity of oxaliplatin-based TNT, associated with considerably reduced HrQoL and markedly increased neuropathy-related symptom burden at follow-up.
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000309947 650_7 $$2Other$$aCIPN
000309947 650_7 $$2Other$$aoxaliplatin
000309947 650_7 $$2Other$$apolyneuropathy
000309947 650_7 $$2Other$$arectal cancer
000309947 650_7 $$2Other$$atotal neoadjuvant therapy
000309947 7001_ $$aHinz, Andreas$$b1
000309947 7001_ $$aSchneider, Melanie$$b2
000309947 7001_ $$aBecker, Jan-Niklas$$b3
000309947 7001_ $$aFrerker, Bernd$$b4
000309947 7001_ $$aVorbach, Samuel M$$b5
000309947 7001_ $$00000-0001-6177-1755$$aEhret, Felix$$b6
000309947 7001_ $$aDiefenhardt, Markus$$b7
000309947 7001_ $$aSchunn, Fabian$$b8
000309947 7001_ $$avon Gruben, Maria-Elena$$b9
000309947 7001_ $$0P:(DE-HGF)0$$aBüttner, Marcel$$b10
000309947 7001_ $$0P:(DE-HGF)0$$aHoffmann, Elgin$$b11
000309947 7001_ $$0P:(DE-He78)80e100a16534f5fc67f7436ee67a47f9$$aRühle, Alexander$$b12$$udkfz
000309947 7001_ $$aBeier, Josephine$$b13
000309947 7001_ $$aFerdinandus, Simone$$b14
000309947 7001_ $$aTrommer, Maike$$b15
000309947 7001_ $$aSahin, Ezgi Ceren$$b16
000309947 7001_ $$aHlouschek, Julian$$b17
000309947 7001_ $$aAninditha, Kynann$$b18
000309947 7001_ $$avon Ohlen, Daphne Schepers$$b19
000309947 7001_ $$aKaufmann, Justus$$b20
000309947 7001_ $$aDepardon, Alina$$b21
000309947 7001_ $$aHa, Hai Minh$$b22
000309947 7001_ $$aKessler, Christopher$$b23
000309947 7001_ $$aCieslak, Adrianna$$b24
000309947 7001_ $$aTrommer, Simon$$b25
000309947 7001_ $$00000-0003-2415-527X$$aFabian, Alexander$$b26
000309947 7001_ $$aRißner, Florian$$b27
000309947 7001_ $$aRömer, Maximilian$$b28
000309947 7001_ $$aPietschmann, Klaus$$b29
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