Neurotoxicity of cisplatin +/- reduced glutathione in the first-line treatment of advanced ovarian cancer

Several drugs have been proposed for chemoprevention from cisplatin (CDDP)-induced neurotoxicity. For the purpose of this study the effectiveness of reduced glutathione (GSH) during CDDP-based first-line treatment was evaluated in a series of 54 patients affected by epithelial ovarian cancer. Neurotoxicity was assessed by clinical examination, vibrametry and neurophysiology before, during and after chemotherapy. First of all, it is noteworthy that GSH cotreatment did not impair CDDP antineoplastic effectiveness. Non-neurological side effects were similar in the two groups, with the exclusion of oliguria which occured more frequently in CDDP alone-treated patients. From a neurological point of view, the comparison between CDDP alone and CDDP+GSH treated groups at the end of treatment (CDDP total dose 500-675 mg m(-2)) constantly evidenced a trend toward less severe neurotoxcity after cotreatment with all methods. Although neuroprotection was not complete, these findings are in agreement with previous preclinical and clinical data and further support the view that chemoprevention with GSH should be considered in CDDP-treated patients.