The Clinical Effect of Triglyceride Glucose Index, an Insulin Resistance Marker, in Predicting Neuropathy Induced by the FOLFOX Chemotherapy Protocol

Objective: FOLFOX chemotherapy protocol is a chemotherapeutic agent used in both adjuvant and neoadjuvant chemotherapy of many malignancies such as colon, rectum, stomach, gallbladder, and pancreatic cancer. Despite its therapeutic efficacy, neuropathy is the most dose-limiting factor. The treatment of neuropathy has not been determined yet. Many clinical studies are ongoing for the treatment and prevention of neuropathy. In our study, we aimed to examine the relationship between insulin resistance and neuropathic pain due to FOLFOX chemotherapy protocol.

Materials and Methods: The triglyceride glucose index (TyG-I) before the first chemotherapy, at the 3rd and 6th months of the patients who developed neuropathic pain within 6 months and did not develop neuropathic pain in the patients who underwent FOLFOX chemotherapy protocol due to the diagnosis of cancer, was calculated. Neuropathy pain score was calculated using a validated test, the DN4 neuropathic pain questionnaire. In the pain questionnaire, it was evaluated as neuropathic pain over 4 points. The difference between the patients who developed neuropathic pain and those who did not develop neuropathic pain was evaluated. The effect of TyG-I, an insulin resistance marker, on neuropathic pain was examined.

Discussion and Conclusion: In our study, no difference was found between chemotherapy-induced neuropathic pain and TyG index in patients who underwent FOLFOX chemotherapy protocol. Additional risk factors in the pathophysiology of oxaliplatin-induced neuropathy are limited in the literature. Studies in the literature have not found a relationship between oxaliplatin-induced neuropathy and diabetes. Additional risk factors affecting the development of chemotherapy-induced neuropathy still continue to be the subject of research.