Showing papers on "Chemotherapy-induced peripheral neuropathy published in 2010"

Patient perceptions associated with chemotherapy-induced peripheral neuropathy.

Abstract: Peripheral neuropathies are a common side effect of certain types of chemotherapy drugs, including taxanes, platinum-based drugs, vinca alkaloids, and thalidomide. Neuropathies may last for months or years following treatment and can impact functional performance and quality of life. The purpose of this study was to explore the effects of chemotherapy-induced peripheral neuropathy (CIPN) and neuropathic pain on the lives of patients with cancer. Participants were recruited from an urban outpatient medical oncology clinic in West Central Florida. Semistructured, private interviews with 14 participants were conducted and transcripts were reviewed for symptoms and effects. Participants often had difficulty describing neuropathic symptoms but reported simultaneous pain or discomfort and loss of sensation in the upper and lower extremities. Injuries secondary to numbness, muscle weakness, and loss of balance were reported. Neuropathic symptoms interfered with many aspects of daily life and participants voiced feelings of frustration, depression, and loss of purpose as a result of having to give up enjoyable activities. The results of this study emphasize the importance of ongoing assessment and communication with patients about their experiences with peripheral neuropathies. Knowledge of what patients with CIPN experience will guide nurses in suggesting interventions to promote safety and help alleviate symptoms.

Measures of chemotherapy‐induced peripheral neuropathy: a systematic review of psychometric properties

Abstract: Chemotherapy-induced peripheral neuropathy (CIPN) remains the principal dose-limiting toxicity of many agents. This systematic review evaluates available CIPN measures and provides rationale for selection of measures in this field. Searches of Medline (1966-2010), CINAHL (1966-2010), Embase (1966-2010), and Cochrane (1988-2010) databases were performed. To be selected, studies had to include (1) subjects receiving peripheral neurotoxic chemotherapy for cancer and (2) a primary purpose of psychometric evaluation of CIPN measures. A modified Quality of Diagnostic Accuracy Studies (QUADAS) tool coded psychometric study quality, with 0-7 score overall possible (higher score indicating better quality). A total of 15 studies qualified for evaluation. Overall studies were of moderate quality, with 10 of 15 receiving a 4-5 QUADAS score. Averaged quality scores for two repeatedly studied measures, Total Neuropathy Score (TNS) versions and Functional Assessment of Cancer-Gynecologic Oncology Group, neurotoxicity (FACT/GOG-Ntx), were 5.4 and 4.5, respectively. Two measures emerged as potentially useful for clinical trials and patient care. The FACT/GOG-Ntx is a subjective measure of CIPN-related quality of life (QoL). TNS clinical versions incorporate both subjective measures and objective examinations of nerve function. However, to improve QUADAS scoring, additional research is needed focusing on other psychometric aspects such as responsiveness of CIPN outcome measures.

Surviving Chemotherapy for Colon Cancer and Living with the Consequences

Abstract: Background: This article discusses peripheral neuropathy as a long-term side effect of oxaliplatin based chemotherapy, from a colon cancer survivor's perspective. Peripheral neuropathy is a common side effect of chemotherapy that affects quality of life for many cancer survivors. Severe and debilitating neuropathy negatively impacts both physical and emotional well-being. Discussion: A better understanding of what cancer survivors with peripheral neuropathy experience is essential for health care professionals. More emphasis on symptom management and development of evidence based interventions will help improve quality of life for those who are affected by chemotherapy induced peripheral neuropathy.

Chemotherapy-induced peripheral neuropathy: An unresolved issue

Abstract: Introduction Chemotherapy-induced peripheral neuropathy (CIPN) is the most prevalent neurological complication of cancer treatment, affecting a third of all patients who undergo chemotherapy CIPN impairs functional capacity, compromises the quality of life and results in dose reduction or cessation of chemotherapy, representing a dose-limiting side effect of many antineoplastic drugs In addition to classic, novel agents, bortezomib and oxaliplatin have been shown to have a significant risk of CIPN Methods By reviewing literature, this article analyses relevant issues and recent advances regarding the pathogenesis, incidence, risk factors, diagnosis, characteristics and management of CIPN Results Research into the pathophysiology and identification of risk factors for individual patients is growing A future avenue of investigation includes the identification of patients at lower or higher risk based on their genotype Best tools for CIPN assessment are not defined Many agents have been claimed to be neuroprotectors without showing significant results in large randomised clinical trials Conclusions Early recognition and subsequent dose reduction/discontinuation of the offending agent is the only way to minimise the development of this potentially debilitating complication Due to the lack of effective prophylactic or symptomatic treatments up to now, neurological monitoring should be recommended in patient candidates to be treated with neurotoxic antineoplastic agents, mainly when they present baseline neuropathy Development of reliable methods for CIPN assessment is essential

Risk of chemotherapy-induced peripheral neuropathy in large population-based cohorts of elderly patients with breast, ovarian, and lung cancer.

Abstract: There is little information on chemotherapy-induced peripheral neuropathy (PN) for community-dwelling patients with cancer. We studied 65,316 patients with breast cancer, 9242 with ovarian cancer, and 86,278 with non-small cell lung cancer from 1991 through 2002 identified from the 16 areas of Surveillance, Epidemiology and End Results. The incidence density of PN was 15.3, 21.5, and 18.3 per 1000 person-years for patients with breast, ovarian, and lung cancer who received platinum-taxane combination chemotherapy, respectively. Patients with breast, ovarian, and lung cancer receiving taxanes were more than twice as likely to develop PN compared with those not receiving chemotherapy (adjusted hazard ratio = 2.22, 95% confidence interval = 1.85-2.66 in patients with breast cancer), whereas patients who received platinum-taxane combination chemotherapy were more than 3 times as likely to develop PN compared with women who did not receive chemotherapy (adjusted hazard ratio = 3.33, 95% confidence interval = 2.05-5.05). In patients with ovarian or lung cancer receiving taxanes or platinum-taxane combination therapy, the risk of PN was increased with increasing number of chemotherapy cycles. These findings remained similar after adjusting for the history of preexisting PN or diabetes. Close monitoring for PN in patients receiving taxanes alone or in combination with platinum compounds may be warranted.

Increased interleukin-6 activity associated with painful chemotherapy-induced peripheral neuropathy in women after breast cancer treatment.

Abstract: Accumulating evidence suggests that neural-immune interactions are involved in the development of painful chemotherapy-induced peripheral neuropathy, particularly through the increased release of proinflammatory cytokines. The purpose of this study was used to evaluate levels of interleukin [IL]-6 and IL-6 receptors in women with breast cancer after the conclusion of chemotherapy who either had painful symptoms of chemotherapy-induced peripheral neuropathy (CIPN group, N = 20) or did not experience CIPN symptoms (Comparison group, N = 20). CIPN participants had significantly higher levels of IL-6 and soluble IL-6R (sIL-6R) compared to women without CIPN symptoms (P < .001 for both). In addition, soluble gp130, which blocks the IL-6/sIL-6R complex from binding to gp130 within the cellular membrane, was significantly lower (P < .01). Circulating concentrations of sIL-6R were inversely correlated with the density of IL-6R on the cell surface of monocytes in the total sample (r = -.614, P = .005). These findings suggest that IL-6 transsignaling may be an important biological mechanism associated with the persistence of painful CIPN symptoms, with potential implications for symptom management and research.

Characteristics and Quality of Life in Patients with Chemotherapy-Induced Peripheral Neuropathy

Abstract: Purpose: The purpose of study was to identify how patients experienced chemotherapy-induced peripheral neuropathy (CIPN) and quality of life related to CIPN. Methods: This was a descriptive research. We collected data from 105 patients with chemotherapy-induced peripheral neuropathy. They completed a self-reported questionnaire including EORTC (Eastern Cooperative Oncology Group) CIPN20 and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Results: In the study, duration of peripheral neuropathy was 9.4 month and 54.3% of patients used pharmacological or non-pharmacological interventions. Patients reported the highest score for sensory scale and it’s score was 38.74±20.24. The scores for motor scale and autonomic scale were 21.95±19.19 and 26.61±21.0 respectively. This showed that patients more suffered from sensory neuropathy than any other domain of neuropathy. The most frequently selected two items were ‘did you have tingling fingers or hands?’ and ‘did you have tingling toes or feet?’. Conclusion: The results of this study will provide useful information for chemotherapy-induced peripheral neuropathy.

Role of erythropoeitin in prevention of chemotherapy-induced peripheral neuropathy.

Abstract: Neurotoxicity complicates the use of several commonly administered chemotherapeutic agents (platinum based alkylating agents, taxanes and vinca alkaloids), with chemotherapy-induced peripheral neuropathy being the most common manifestation. Structural damage to the peripheral nervous system results in positive symptoms, e.g., allodynia, hyperalgesia and pain with unpleasant features as burning and shooting. Patients are unable to complete full or optimal treatment schedules. The pathophysiologic basis of nerve injury in chemotherapy-induced peripheral neuropathy is incompletely understood and appears to be unique for each class of the chemotherapeutic agents. Erythropoeitin (EPO), a well-established hematopoietic factor, is a very effective and widely used treatment for anemia in cancer patients undergoing chemotherapy. It also possesses generalized neuroprotective and neurotrophic properties. Co-treatment of chemotherapy and erythropoietin has been proposed for preventing or reversing the disabling peripheral neuropathy induced by the different chemotherapeutic agents. This study first describes the pathophysiological background of the clinically relevant chemotherapeutic agents-inducing peripheral neuropathy. Secondly, the possible mechanisms that might underlie the neuroprotective effect of erythropoietin in chemotherapy-induced neuropathy. Further clinical trials of EPO in cancer patients receiving chemotherapy and suffering from neurological symptoms seem to be warranted in the future. This might improve the quality of life in cancer patients.

Chemotherapy-Induced Peripheral Neuropathy in Cancer Survivors

Abstract: Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most challenging and complex complications of cancer chemotherapy.

Radio Frequency Ablation in Drug Resistant Chemotherapy-induced Peripheral Neuropathy: A Case Report and Review of Literature

Abstract: Chemotherapy-induced peripheral neuropathy (CIPN) is a frequently encountered complication. It can result from a host of agents. Various modalities of treatment have been advocated, of which a novel method is radio frequency ablation. A 63-year-old male, a case of carcinoma prostrate with bone metastases, presented with tingling and numbness in right upper limb. He was given morphine, gabapentin and later switched to pregabalin, but medications provided only minor relief. Initially he was given stellate ganglion block, then radiofrequency ablation of dorsal root ganglion was done, but it failed to provide complete relief. Pulsed radiofrequency ablation (PRF) was then done for 90 seconds; two cycles each in both ulnar and median nerve. After the procedure the patient showed improvement in symptoms within four to five hours and 80% relief in symptoms. We conclude that PRF can be used for the treatment of drug resistant CIPN.

Chemotherapy Induced Peripheral Neuropathy: Risk Factors, Pathophysiology, Assessment, and Potential Physical Therapy Interventions

Abstract: &NA; Chemotherapy induced peripheral neuropathy (CIPN) affects many people treated for various types of cancer. Though advances in cancer treatment have led to improved survival rates, patients are now exposed to greater levels of neurotoxic agents, resulting in increased incidence of CIPN. Symptoms of CIPN include pain, sensory loss, proprioceptive deficits, distal weakness, decreased fine motor control, reduced balance, and gait impairments. Chemotherapy induced peripheral neuropathy interferes with function, social roles, and quality of life. The purpose of this literature review is to present chemotherapeutic agents frequently associated with peripheral neuropathy, describe pathogenesis and symptoms, and describe potential impact of the physical therapist in assessment and treatment of persons affected by CIPN.

Treatment of chemotherapy-induced peripheral neuropathy (CIPN) with topical menthol: A phase I study.

Abstract: 9129 Background: CIPN is a common dose-limiting toxicity. Mostly symptoms resolve several months post-treatment, but a significant proportion of patients are left with long-term pain and disability which is difficult to treat. The available systemic agents have limited efficacy, cause significant side effects and take several weeks/months to work. Based on preclinical work showing marked analgesic effects of topical transient receptor potential melastatin (TRPM8) receptor activators in neuropathic pain (Proudfoot, Curr Biol 2006;16;1591-1605) we conducted a phase I study of topical menthol. Methods: 22 patients with long-term CIPN a median of 17 months (range 2 to 35) post-treatment with bortezomib (n=2), carboplatin (n=1), docetaxel (n=2), cisplatin (n=3), and oxaliplatin (n=14) applied 1% topical menthol, twice daily to affected areas and skin overlying the corresponding dorsal root ganglia. At baseline, 2 and 6 weeks, patients completed: Brief Pain Inventory (BPI–measures pain severity and interference...

Clinical Observation to Combination Treatment of Lipoic Acid and Analgecine for Chemotherapy-induced Peripheral Neuropathy

Abstract: Objective To observe the clinical effect of Lipoic acid and Analgecine on peripheral neuropathy induced by anticancer drugs.Methods Forty-three patients with chemotherapy-induced peripheral neuropathy were given lipoic acid(600 mg) with intravenous infusion of analgecine(7.2 U),once a day,2 weeks.The changes of clinical symptoms and signs were compared between pre-and post-treatment.Results There was significant difference in MCV of median nerve and common peroneal between pre-and post-treatment(P0.05).The visual analogue scale(VSA) was(5.2±2.5) before treatment,and(1.9±1.2) after treatment,the difference was significant(P0.01).The posttreatment efficiency was 83.72%,total effective rate 95.34%.Conclusion Lipoic acid combined with analgecine can improve effectively the peripheral nerve symptoms after chemotherapy of malignant tumors.