Journal of Current Biomedical Reports jcbior.com Volume 3, Number 2, 2022 eISSN: 2717-1906 1 Original research The characterization of oxaliplatin-induced peripheral neuropathy using electromyography in gastrointestinal cancer patients Babak Bakhshayesh Eghbali 1 , Sara Ramezani 1 , Hamid Saeidi Saedi 2 , Nazanin Rahman Amlash 3 , Ehsan Kazemnezhad Leili 4 , Hamidreza Hatamian 1 , Cyrus Emir Alavi 1,* 1 Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran 2 GI Cancer Screening and Prevention Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran 3 Student Research Committee, Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran 4 Road Trauma Research Center, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran Abstract Oxaliplatin-induced peripheral neuropathy (OIPN) is a common dose-dependent chemotherapy complication in gastrointestinal cancer (GIC). This side effect may restrict therapeutic dose elevation of oxaliplatin. Here, OIPN frequency and determinants of neuropathy appearance in oxaliplatin-treated GIC patients. A total of 102 GIC patients who underwent chemotherapy with fluorouracil, folinic acid and oxaliplatin (FOLFOX4) regimen participated in this longitudinal study. Electromyography (EMG) was accomplished for ulnar, radial, sural, peroneal nerves and superficial peroneal nerve (SPN) before, 3, and 6 months after treatment. National Cancer Institute-Common Toxicity Criteria V.3 and clinical version of the Total Neuropathy Score were used for the neuropathy diagnosis at six months after treatment onset. Of all entered patients, twelve people discontinued this study, and five patients passed away. About 85 patients remained three and six months after chemotherapy onset. Approximately 95% of patients three months after chemotherapy demonstrated OIPN manifestations. Finally, data for 81 patients having neuropathy were analyzed. Mean age of patient 64.0±10.9 years. There were about 3.7%, 30.9%, 63% grade III, II, I of neuropathy, respectively. Interestingly, a significant decrease in action potential (AP) amplitude of SPN, sural and radial nerves but not ulnar and peroneal was observed after treatment onset. However, only the ulnar nerve indicated a substantial deceleration of nerve conduction. Age, sex, weight, past medical diseases, smoking and acute neuropathy were not significantly associated with OIPN. The occurrence of OIPN is detectable by electrophysiological changes of SPN, radial, and sural nerves at three and six months after starting chemotherapy with the FOLFOX4 regimen. Keywords: Oxaliplatin, Neuropathy, Gastrointestinal cancer, Chemotherapy, Electromyography 1. Introduction Platinum compounds such as cisplatin, carboplatin, and oxaliplatin are among the alkaline agents that limit deoxyribonucleic acid (DNA) * Corresponding author: Cyrus Emir Alavi, MD Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Tel/Fax: +98 13 33325783/+98 13 33339842 Email: cyrusemiralavi@yahoo.com https://orcid.org/0000-0003-1664-0822 Received: November, 22, 2021 Accepted: February, 12, 2022 synthesis . Cisplatin is used to treat especially metastatic gastrointestinal cancers (GICs) [1-3]. Oxaliplatin is used as a platinum analog and as a major component of a standard chemotherapy approach © The Author(s) 2022