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Oxaliplatin Cold Sensitivity — SCE Medical Oncology MCQ

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EasyGI CancersOxaliplatin Cold SensitivitySCE Medical Oncology

A 55-year-old man with CRC on FOLFOX develops Raynaud-like cold sensitivity in his fingers during winter. What causes this and how is it managed?

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Correct answer: B — Acute oxaliplatin-related cold-triggered neurotoxicity

Oxaliplatin causes acute cold-triggered toxicity through voltage-gated sodium channel dysfunction. Beyond the well-known acute peripheral nerve symptoms (paraesthesia, dysaesthesia), it can cause Raynaud-like digital vasospasm and cold-induced muscle cramping. Management: avoid cold exposure for 3-5 days post-infusion (warm gloves, avoid cold drinks/foods, cover face in cold weather). This is distinct from chronic cumulative neuropathy. Calcium-magnesium infusions were evaluated but RCTs (CONcePT) showed no clear benefit.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer