Table 4 Dose modification criteria, toxicity assessment tools, haematological and gastro-intestinal side effects
Study author | Starting dose of oxaliplatin | Dose modification criteria | Toxicity assessment tool | Haematological toxicity | GI toxicity |
|---|---|---|---|---|---|
Andre [14] | 85Â mg/m2 | -Oxaliplatin reduced by 25% for grade 3 thrombocytopenia or grade 4 diarrhea, and by 50% if grade 4 thrombocytopenia | -NCI-CTC | Grade 4 leukopenia, grade 3 thrombocytopenia & grade 3 anemia | Grade 4 stomatitis and grade 4 diarrhea. |
Pfeiffer [29] | 130Â mg/m2 | -Oxaliplatin: 25% reduction for febrile neutropenia, grade 4 thrombocytopenia or grade 3/4 GI toxicity. Additional 25% reduction if the above toxicity recurs. | -NCI-CTC v2.0 | Acute grade4 neutropenia (1.4%) | Acute grade 3 stomatitis (1.4%) |
Rothenberg [8] | 85 mg/m2 | -Dose of oxaliplatin reduced by 24% for grade 3/4 febrile neutropenia, thrombocytopenia, nausea vomiting, diarrhoea and grade 4 stomatitis. Discontinue for grade 3/4 allergic reaction. | -NCI-CTC v2.0 | Anemia: all grades = 98 (64%) and grades 3–4 = 2(1%). Thrombocytopenia: all grades = 46 (30%) and grades 3–4 = 4 (3%). Neutropenia: all grades = 10 (7%). | - Diarrhea all grades: 70 (46%) & grades 3–4: 6 (4%). Nausea: all grades 98 (64%) & grades 3–4: 6(4%). Vomiting: all grades = 57 (37%) and grades 3–4 = 6 (4%). Stomatitis: all grade = 21 (14%). |
Schmoll [37] | 130Â mg/m2 | -Oxaliplatin: 23% reduction for grade 3/4 nausea or vomiting, grade 4 stomatitis, and for paresthesias with pain or functional impairment lasting for more than 7Â days, or paresthesias with pain persisting between cycles | -NCI-CTC v3.0 | Grade 3/4 neutropenia (4-20%) | acute grade 3/4 diarrhea on day1 (19%). |
Shields [34] | 130 mg/m2 | Oxaliplatin: 25% reduction for grade 3 thrombocytopenia, grade4 neutropenia mucositis & diarrhea, grade 3/4 emesis and paresthesia persisting b/n cycles. 40% for grade 4 thrombocytopenia and 50% for paresthesia impairing function | -NCI-CTC v2.0 | NR | Diarrhea 1 (7.7%) |
Sorbye [35] | 85Â mg/m2 | -Oxaliplatin: 25% reduction for persistent paresthesia b/n cycles. Second 25% reduction if no improvement | - NCI-CTC v2.0 -Oxaliplatin specific neurotoxicity scale | Acute grade 4 leukopenia 1 (1.2%) Acute allergic reaction 1 (1.2%) | Acute stomatitis 1 (1.2%) |