Treatment of Chemotherapy - Induced Peripheral Neuropathy: The Physicians Need Guidelines, the Patients Need Help
Keywords:Chemotherapy induced peripheral neuropathy, neuropathy, neuropathic pain, cancer related pain, pain treatment, amitiptyline, gabapentin, oxycodone, treatment schedule, pain, tactile allodynia, brush allodynia.
The aim of the study was to verify the effectiveness of two methods of introducing standard CIPN-treatment drugs into the therapy.
Materials and Methods: Group A included patients attending weekly appointments, while group B monthly. Standard treatment with amitriptyline, gabapentin (GAB), and oxycodone (OXY) was administered. In group A, the drugs were gradually introduced, while in group B - within one week. After a month and six months of treatment, the therapy effectiveness was assessed by examination of pain intensity (VAS), symptoms of peripheral neuropathy (sNCI-CTC), occurrence of tactile and brush allodynia, and the daily dose of GAB andOXY.
Results: Pain intensity during the study decreased from 5.59 to 2.9 and 2.76 in group A, and from 5.07 to 2.52 and 2.81 in group B. The sNCI-CTC values declined too and were, respectively. 1.9; 1.48; 1.34 in group A and 1.93; 1.52; 1.44 in group B. Tactile allodynia occurred in 15; 5; 5 group A patients and 18; 6; 5 group B patients. Brush allodynia decreased in group A (9; 5; 5) and B (11; 6; 5). The daily GAB dose was 0; 951.72; 927.41 in group A and 900.0; 900.0; 1000.0 in group B. The daily OXY dose was 0; 21.72; 22.07 in group A and 20.0; 20.0; 27.04 in group B; a statistically significant difference was found in the final stage.
The results do not allow recommendation of non-schematic treatment and they should be regarded as a preliminary study. Randomized trials are indispensable for assessment of advantages and drawbacks such treatment.
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