The main safety concern regarding the use of oxaliplatin is peripheral neuropathy. Oxaliplatin induces
frequent, transient, distal paresthesias during or shortly after the first minutes of infusion. In
some cases these neurosensory symptoms increase in intensity with cumulative doses, persist between
cycles, and interfere with function (in the case of grade 3 effects).We observed grade 3 peripheral
neuropathy in 12.4 percent of patients who were receiving oxaliplatin. At one year, 11 patients
(1.1 percent) had grade 3 neuropathy. Among them,two were found to have underlying disease that
could have caused these symptoms (diabetes and hemiplegia, respectively). Although more frequent
among patients receiving FL plus oxaliplatin than among those treated with FL alone, grade 3 or 4 neutropenia led to fever or infection in only 1.8 percent of patients in the former group. Similar findings have been reported among patients with metastatic colorectal cancer.
From a safety standpoint, the rate of death from any cause was similarly low during treatment in both groups and, at 0.5 percent, is among the lowest figures reported in trials of adjuvant chemotherapy.