Protective effect of N-acetylcysteine on oxaliplatin-induced peripheral neuropathy in colorectal cancer: a randomized controlled trial.
Zeyad K Hegazy, Sahar K Tawfik, Nehal M Elmashad
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In 30 seconds
This randomized controlled trial evaluated oral N-acetylcysteine (NAC) for preventing oxaliplatin-induced peripheral neuropathy in 46 patients with stage III or high-risk stage II colorectal cancer receiving adjuvant modified FOLFOX-6. Participants received NAC 1200 mg or placebo before oxaliplatin infusions for four cycles. Compared with placebo, NAC was associated with lower neuropathy scores at the end of the first two cycles and treatment, and reduced pain interference. Serum interleukin-6 and neurotensin were also lower after treatment in the NAC group. The abstract reports statistical significance but no effect sizes.
Key findings
- FACT/GOG-NTX-12 and NCI-CTCAE neuropathy scores were significantly lower with NAC at the end of the first two cycles and treatment (P < 0.05).
- Pain interference was significantly reduced with NAC at both assessment time points (P < 0.001); pain severity was not significantly reduced.
- After treatment, neurotensin and IL-6 were significantly lower in the NAC group than in controls (both P < 0.001).
Why it matters
Oxaliplatin-related neuropathy can limit chemotherapy delivery. This trial suggests that NAC given alongside adjuvant FOLFOX may lessen measured neuropathy and its interference with daily activities, while also changing serum biomarkers. The findings are clinically relevant as a potential supportive-care approach, but the abstract does not provide effect sizes to judge the magnitude of benefit.
What to keep in mind
The trial included 46 patients and assessed outcomes over four chemotherapy cycles; the abstract provides no effect sizes or longer-term neuropathy outcomes.