Efficacy and safety of intravenous administration of high-dose selenium for preventing chemotherapy-induced peripheral neuropathy in gastric cancer patients receiving adjuvant oxaliplatin and capecitabine after gastrectomy: a retrospective pilot study.

Abstract

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting toxicity associated with oxaliplatin-based chemotherapy in gastric cancer patients. Recent studies suggest that high-dose intravenous selenium may exert neuroprotective effects in patients receiving platinum-based chemotherapy.

Methods: This pilot study analyzed patients with stage III gastric adenocarcinoma who underwent gastrectomy between January and December 2024. A total of 28 patients receiving adjuvant capecitabine plus oxaliplatin (XELOX) chemotherapy were included and divided into two groups: one receiving chemotherapy alone (non-selenium: n= 17) and the other receiving an intravenous injection of selenium (2,000 µg/day) before chemotherapy (selenium: n= 11). CIPN severity was assessed after the first chemotherapy cycle and at the completion of chemotherapy using standardized grading criteria.

Results: Baseline clinicopathological characteristics, including age, sex, body mass index, preoperative comorbidities, extent of resection, operation time, and hospital stay, were comparable between groups. No adverse events related to high-dose selenium administration were observed. There were no significant differences in chemotherapy-related adverse events, such as hand-foot syndrome, nausea, vomiting, diarrhea, and loss of appetite, between the two groups. While CIPN severity was similar between groups after the first chemotherapy cycle, by the end of chemotherapy, the selenium group exhibited significantly lower paresthesia severity compared to the non-selenium group (P < 0.0001).

Conclusion: High-dose intravenous selenium appears to be a safe and potentially effective intervention for reducing paresthesia associated with oxaliplatin-based chemotherapy. Further large-scale prospective studies are warranted to validate these findings and establish optimal dosing guidelines.