**4. Risks and other conditionings for CIPN**

It is difficult to establish in humans exactly the timing of changes on peripheral nerves after a pharmacological insult. Even though we know the day chemotherapy starts, there are different risk factors than makes neuropathy more probable in one patient than another. In **Table 2** are listed the most known of them. In particular, one of such factors is the cumulative dose, especially for platinum agents. It was demonstrated that high-dose cisplatin was intrinsically more neurotoxic [23]. There is a range between 300 and 400 mg/m2 from which sensory symptoms starts to be persistent and from 540 to 850 mg/m2 from which the CIPN is generally stablished with high risk to be a long-term condition. However, we know now that there is no specific dose to be secure and probable neurotoxicity starts from first dose with a cumulative effect within sensory neurons.


**Table 2.** *General risk factors for CIPN.*

#### *Neurotoxicity - New Advances*

One phenomenon that usually appears with platinum agents (cisplatin and oxaliplatin) is the coasting effect. It refers to the further progression of neurotoxicity during 3 to 6 months after stopping the treatment that results from its capacity to accumulate in DRG for a long time. It was described first for cisplatin [18, 27, 28] and later for oxaliplatin [9, 29, 30]. This surprises the patient who frequently ask worried because of deterioration of their sensory deficits after treatment was stopped.
