Motor dominant neuropathy induced by adjuvant therapy with adriamycin and cyclophosphamide followed by dose-dense paclitaxel in a breast cancer patient

Int J Clin Oncol. 2006 Aug;11(4):332-5. doi: 10.1007/s10147-006-0578-1.

Abstract

A 38-year-old woman underwent mastectomy and axillary lymph node dissection for invasive ductal carcinoma with multiple lymph node involvement. The patient received adriamycin 60 mg/m(2) and cyclophosphamide 600 mg/m(2) followed by weekly paclitaxel 80 mg/m(2) (without interruption) as adjuvant treatment. After receiving ten courses of paclitaxel, the patient developed motor neuropathy, with difficulty in ascending stairs and rising from a chair. A nerve conduction study demonstrated impairment of bilateral peroneal nerve function, although the sural sensory nerves were intact. After 2 weeks of withholding paclitaxel treatment, the motor neuropathy was alleviated and the scheduled doses were completed. A pharmacokinetic study of paclitaxel showed the possibility of elimination delay at the last infusion. We suggest that a dose-dense schedule of paclitaxel may be a significant risk factor for this kind of motor neuropathy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Breast Neoplasms / drug therapy*
  • Carcinoma, Ductal, Breast / drug therapy*
  • Chemotherapy, Adjuvant / adverse effects
  • Cyclophosphamide / administration & dosage*
  • Dose-Response Relationship, Drug
  • Doxorubicin / administration & dosage*
  • Female
  • Humans
  • Motor Neuron Disease / chemically induced
  • Paclitaxel / administration & dosage*
  • Peripheral Nervous System Diseases / chemically induced*

Substances

  • Doxorubicin
  • Cyclophosphamide
  • Paclitaxel