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A prospective cohort study of the orofacial effects of vincristine neurotoxicity.

Neurotoxicity is the dose-limiting side effect of vincristine sulfate. This study was designed to investigate neurotoxicity affecting the head and neck in a population of cancer patients receiving vincristine. Forty patients were given baseline interviews and oral examinations, and these were repeated weekly for the first 7 wk of treatment. Twenty-six patients (65%) developed symptoms of neurotoxicity: orofacial pain, 22/40 (55%); numbness 1/40 (2.5%); paresthesia 4/40 (10%); difficulty with mastication 1/40 (2.5%); involuntary movements 3/40 (7.5%); and voice changes, 4/40 (10%). Most symptoms occurred in the first week except voice changes (hoarseness and weakness) which did not occur until the third week of treatment. Using Fisher's exact test, neurotoxicity affecting the orofacial area was found to be significantly associated with younger age and single marital status indicating that psychosocial factors may affect susceptibility to the neurotoxic effects of vincristine. This prospective cohort study confirms previous anecdotal reports of vincristine neurotoxicity affecting the head and neck.