Discussion
colorectal cancer, comorbidity, long-term CIPN, neuropathy, CIPN, neurotoxicity, acute neuropathy, diabetes
DIABETES, COLORECTAL CANCER, NEUROPATHY
CIPN was a long-term problem for many patients in the SCOT trial regardless of the chemotherapy duration and regimen. We found a link between baseline neuropathy and long-term CIPN for up to 24 months after the start of treatment (we ceased statistical analysis at 24 months). Age, sex, and BMI were not associated with CIPN. Shorter duration of chemotherapy (3 months versus 6 months as already demonstrated by the SCOT trial) and CAPOX regimen were associated with lower severity of acute and long-term CIPN. We also observed the phenomenon of coasting. This is when symptoms worsen after treatment discontinuation.The relationship of acute CIPN with long-term CIPN has been shown in other studies.The literature remains conflicting on patient factors that predispose CIPN. A systematic review on risk factors for oxaliplatin-indicted neurotoxicity in patients with colorectal cancer found 15 studies reporting demographics, comorbidity (diabetes), and severity of acute neuropathy influencing CIPN.Differences in CIPN occurrence and severity are clearly influenced by the cumulative dose of oxaliplatin. This was shown in a number of RCTs comparing 3 months to 6 months of treatment,