Preventive and Inhibitory Effects of Goshajinkigan with Respect to Neurotoxicity Induced by mFOLFOX6 in Colorectal Cancer Therapy

We investigtated the preventive and inhibitory effects of goshajinkigan with regard to oxaliplatin-induced peripheral neuropathy in 29 patients who received mFOLFOX6 (± bevacizumab) for colorectal cancer in the Department of Surgery at Gunma Saiseikai Maebashi Hospital, from January to December 2010. A comparison was made between 3 groups: prophylactic coadministration of goshajinkigan group (combined with mFOLFOX6 at beginning (± bevacizumab)), therapeutic coadministration of goshajinkigan group (combined with mFOLFOX6 at onset of peripheral neuropathy (≦ grade1)) group and no goshajinkigan group. The endpoints were grade changes in peripheral neuropathy associated with continuous mFOLFOX6 (± bevacizumab), inhibitory effect ≧ grade1 and ≧ grade2 neurotoxicity in relation to the total dose of oxaliplatin, and TTF of mFOLFOX6 (± bevacizumab). The inhibitory effect with respect to peripheral neuropathy and TTF were investigated using Kaplan-Meier analysis and tested by the Log-Rank test.The results for all endpoints suggested that goshajinkigan had preventive and inhibitory effects in oxaliplatin-induced peripheral neuropathy where prophylactic coadministration of goshajinkigan > therapeutic coadministration of goshajinkigan> no goshajinkigan. Prophylactic coadministration of goshajinkigan achieved a significant inhibitory effect in grade 2 or worse peripheral neuropathy in relation to the total dose of oxaliplatin (p=0.002). These findings suggest that goshajinkigan can be used as a prophylactic and therapeutic agent in oxaliplatin-induced peripheral neuropathy.