Efficacy of the traditional Chinese medicine, Buyang Huanwu Decoction, at preventing taxane-induced peripheral neuropathy in breast cancer patients: A prospective, randomized, controlled study
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Abstract:
Buyang Huanwu Decoction (BYHWD) is a traditional Chinese prescription, originally derived from Yi Lin Gai Cuo during the Qing Dynasty. This study aimed to evaluate the efficacy and safety of BYHWD in the prevention of taxane-induced peripheral neuropathy (TIPN) in patients with breast cancer.Keywords:
Chemotherapy-Induced Peripheral Neuropathy
Clinical endpoint
Taxane
To the Editor,Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common side effects of anti-cancer therapy with a reported incidence of approximately 40%, occurring mainly in pat...
Chemotherapy-Induced Peripheral Neuropathy
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Peripheral neuropathy is a frequently occurring side-effect of chemotherapy as a cancer treatment. The incidence of chemotherapy-induced peripheral neuropathy (CIPN) is increasing as a consequence of better treatment of cancer becoming available and increasing use of chemotherapy, and because CIPN occurs more frequently with use of new chemotherapeutics. The diagnosis 'CIPN' is made principally on clinical grounds, and it is characterized by predominantly sensory symptoms. The National Cancer Institute Common Toxicity Criteria (NCI-CTC) are commonly used to grade CIPN, but the reliability of these criteria is debated. If CIPN occurs, the only effective strategies are dose reduction or discontinuation of chemotherapy. CIPN impairs quality of life. It is important to evaluate the symptoms of CIPN, as well as the impact on daily living.
Chemotherapy-Induced Peripheral Neuropathy
Discontinuation
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Background: This study examined the effect of a portable low-frequency electrostimulation (ES) device on patients diagnosed with chemotherapy-induced peripheral neuropathy (CIPN) immediately after chemotherapy for breast cancer. Methods: A single-center, randomized, placebo-controlled trial was conducted. A total of 72 patients newly diagnosed with CIPN were enrolled and randomly placed into the ES (n = 36) or the sham ES group (SES; n = 36). Duloxetine or pregabalin was prescribed to all participants from the initial assessment. The devices for 14 days, at least twice a day, for at least 120 minutes. The primary outcomes were the overall intensities of the CIPN symptoms as assessed using Numerical Rating Scale (NRS). Secondary outcomes included Total Neuropathy Score (TNS), European Organization for Research and Treatment of Cancer Quality of Life (EORTC-QLQ), Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20), Functional Assessment of Cancer Therapy-Breast (FACT-B), and Instrument on Pattern Identification and Evaluation for CIPN (IPIE-CIPN). Results: No differences in NRS scores were found between the patients in the ES and the SES group (P = 0.267). Patients in both groups showed significantly reduced CIPN intensities (ES P < .001; SES P < .001). No significant differences between the groups were found in TNS, EORTC-QLQ, CIPN20, and FACT-B. The general symptoms of CIPN diagnosed as cold arthralgia showed significance only in the ES group (P = .006). Conclusion: Compared with a placebo, the effectiveness of the low-frequency ES device with pharmacological intervention was not significantly different, but a therapeutic effect was possible.
Chemotherapy-Induced Peripheral Neuropathy
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ABSTRACT Chemotherapy induced peripheral neuropathy is a syndrome with distal symmetrical sensorial-dominant pain, tingling and numbness caused by neurotoxic chemotherapeutic agents. The severity increases with cumulative doses of chemotherapy, besides decrease in quality of life, may lead to cessation of treatment which may effect survival. Neurotoxicity causes large fiber and small fiber neuropathy through many pathologic mechanisms including mitochondrial dysfunction and oxidative stress. Dose related neuropathic pain is most commonly seen with taxanes, platins, vinca alkaloids, bortezomib and brentuximab. There is a limited effect of anticonvulsant and antidepressant medication for treatment. In this review awareness about chemotherapy induced peripheral neuropathy, prevention and treatment are discussed. Keywords: Chemotherapy, pain, neuropathy, small fiber neuropathy
Chemotherapy-Induced Peripheral Neuropathy
Neurotoxicity
Vinca
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Taxane
Chemotherapy-Induced Peripheral Neuropathy
Pain medicine
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Peripheral neurotoxicity is a major adverse effect of cisplatin chemotherapy. A prospective observational study was conducted among 200 cancer patients who received cisplatin between October 2017 and March 2018 to evaluate the occurrence, causality and severity of cisplatin induced peripheral neuropathy. A suitable data collection form was used to record patient information required for the study. Peripheral neuropathy was assessed using the National Cancer Institute- Common Terminology Criteria for Adverse Events (NCI-CTCAE). As per the results, 19 (9.5%) patients developed peripheral neuropathy after receiving cisplatin therapy. Peripheral neuropathy was reported higher in males (84.2%) compared to females (15.7%) and more within the age group of 58-65 years (38.6%). Most of the patients developed Grade I neuropathy (84.2%), followed by Grade II neuropathy (15.7%). The study concluded that the severity of peripheral neuropathy increases with higher cumulative doses of cisplatin.
Chemotherapy-Induced Peripheral Neuropathy
Cumulative dose
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Chemotherapy-Induced Peripheral Neuropathy
Pain medicine
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Objective: To analyze the occurrence of tinnitus and peripheral sensory neuropathy in women during breast cancer chemotherapy. Methods: This is a retrospective analytical study with a quantitative approach, performed in medical records of an oncology outpatient service between February 2014 and February 2015, using the toxicities scores of Common Terminology Criteria for Adverse Events (CTCAE). Results: Considering 181 patients with breast cancer who met the inclusion criteria, 49.2% reported tinnitus at some point of the treatment, while 65.1% peripheral sensory neuropathy. In both conditions, the predominant severity score was grade 1, with frequencies of 23.8% and 33.1%, respectively. A significant, positive and weak correlation was observed between the severity of tinnitus and peripheral sensory neuropathy (ρ = 0.325 and p = 0.001), as well as very weak between the number of complete cycles of chemotherapy and tinnitus (ρ = 0.195 and p = 0.009) and neuropathy peripheral sensory (ρ = 0.237 and p = 0.002). Conclusions: Tinnitus and peripheral sensory neuropathy were frequent toxicities during chemotherapy treatment of breast cancer, and both manifested with low severity/functional impact in most participants.
Chemotherapy-Induced Peripheral Neuropathy
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Background: Peripheral neuropathy is a common problem among cancer patients receiving chemotherapy.Chemotherapy-Induced Peripheral Neuropathy (CIPN) may have a significant negative impact on the Quality of Life (QOL) and treatment outcome.Studies showed that High Power Laser Therapy (HPLT) has an effect on peripheral neuropathy. Aim of Study:To investigate the effect of high-power laser therapy on modified total neuropathy score in patients with chemotherapy induced peripheral neuropathy.Patients and Methods: Thirty patients with CIPN, the patients were assigned randomly into two equal groups, study and control groups.The study group were received HPLT with routine medical treatment for 3 days/week for 6 weeks, the control group were received sham laser with routine medical treatment, CIPN was graded according to the modified Total Neuropathy Score (mTNS) to assess the severity of CIPN pre and post-treatment.Results: There was significant decrease of the mean values of mTNS only on the study group.After HPLT, there was a significant decrease in the mean of neuropathy from 11.6±.96before HPLT therapy to 7.8±1.26after HPLT (p<0.0001).The mean difference was 3.26 and the percentage of change was 29.48 (p=0.0001). Conclusion:The results suggest that the use of HPLT has a significant effect on mTNS in patients with CIPN.
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Dear Editor
We have read, with great interest, the recent paper titled ‘Acupuncture for chemotherapy-induced peripheral neuropathy: a randomised controlled pilot study’ by D'Alessandro et al ,1 which evaluated the effect of acupuncture treatment on chemotherapy-induced peripheral neuropathy (CIPN). We would like to highlight additional points of discussion regarding this study.
The author reported that the primary aim of their study was to evaluate the effect of acupuncture treatment in reducing the neurological symptoms of …
Chemotherapy-Induced Peripheral Neuropathy
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