Neurological toxicity of vindesine used in combination chemotherapy of 51 human solid tumors

Abstract

The authors treated 51 patients with solid tumours with vindesine 4 mg/m2, generally every third week, in combination chemotherapy protocols scheduled according to diurnal variability of kinetics. No dose-related sensory disorders were observed: On the contrary, motor toxicity appeared cumulative: 1) Early depression of osteotendinous reflexes from the first course onward, with progressive deterioration. No more normal reflexes could be evoked after 55 mg; 2) Early appearance of neurogenic pattern in the electromyograph after 5-10 mg. Progressive alteration with no normal detection recordings after 45 mg; 3) Late slowing down of conduction speeds (normal in 50% of cases up to 55-60 mg). Improvement or even complete recovery of neuropathy was documented following reduction of the unit dose, increased time interval between doses, or discontinuation of the treatment. The drug had to be withheld in only three patients: in two cases a low dosage related to individual sensitivity was being used.