Anaesthesia and Intensive Care Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Haematology Oncology Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Pediatr Blood Cancer. 2018 Jul;65(7):e27064. doi: 10.1002/pbc.27064. Epub 2018 Apr 6.
Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy, in need of effective treatment. Preliminary data support the efficacy of scrambler therapy (ST), a noninvasive cutaneous electrostimulation device, in adults with CIPN. We test the efficacy, safety, and durability of ST for neuropathic pain in adolescents with CIPN.
We studied nine pediatric patients with cancer and CIPN who received ST for pain control. Each patient received 45-min daily sessions for 10 consecutive days as a first step, but some of them required additional treatment.
Pain significantly improved comparing Numeric Rate Scale after 10 days of ST (9.22 ± 0.83 vs. 2.33 ± 2.34; P < 0.001) and at the end of the optimized cycle (EOC) (9.22 ± 0.83 vs. 0.11 ± 0.33, P < 0.001). The improvement in quality of life was significantly reached on pain interference with general activity (8.67 ± 1.66 vs. 3.33 ± 2.12, P < 0.0001), mood (8.33 ± 3.32 vs. 2.78 ± 2.82, P < 0.0005), walking ability (10.00 vs. 2.78 ± 1.22, P < 0.0001), sleep (7.56 ± 2.24 vs. 2.67 ± 1.41, P < 0.001), and relations with people (7.89 ± 2.03 vs. 2.11 ± 2.03, P < 0.0002; Lansky score 26.7 ± 13.2 vs. 10 days of ST 57.8 ± 13.9, P < 0.001; 26.7 ± 13.2 vs. EOC 71.1 ± 16.2, P < 0.001).
Based on these preliminary data, ST could be a good choice for adolescents with CIPN for whom pain control is difficult. ST caused total relief or dramatic reduction in CIPN pain and an improvement in quality of life, durable in follow-up. It caused no detected side effects, and can be retrained successfully. Further larger studies should be performed to confirm our promising preliminary data in pediatric patients with cancer.
化疗引起的周围神经病（CIPN）是化疗的常见副作用，需要有效的治疗。初步数据支持非侵入性皮肤电刺激设备 scrambler 疗法（ST）在 CIPN 成人患者中的疗效。我们测试了 ST 治疗青少年 CIPN 神经性疼痛的疗效、安全性和持久性。
我们研究了 9 名患有癌症和 CIPN 的儿科患者，他们接受了 ST 治疗以控制疼痛。每位患者接受每天 45 分钟的治疗，连续 10 天作为第一步，但其中一些患者需要额外的治疗。
ST 治疗 10 天后，数字评分量表（Numeric Rate Scale）上的疼痛显著改善（9.22±0.83 与 2.33±2.34；P<0.001），在优化周期结束时（EOC）也显著改善（9.22±0.83 与 0.11±0.33，P<0.001）。生活质量的改善在一般活动的疼痛干扰方面显著达到（8.67±1.66 与 3.33±2.12，P<0.0001）、情绪（8.33±3.32 与 2.78±2.82，P<0.0005）、行走能力（10.00 与 2.78±1.22，P<0.0001）、睡眠（7.56±2.24 与 2.67±1.41，P<0.001）和人际关系（7.89±2.03 与 2.11±2.03，P<0.0002）。兰斯基评分（Lansky score）从 26.7±13.2 改善至 10 天的 ST 治疗后为 57.8±13.9，P<0.001；从 26.7±13.2 改善至 EOC 后为 71.1±16.2，P<0.001）。
基于这些初步数据，ST 可能是青少年 CIPN 患者的一个不错的选择，因为这些患者的疼痛控制较为困难。ST 治疗可完全缓解或显著减轻 CIPN 疼痛，并改善生活质量，随访中具有持久性。ST 没有引起任何可检测到的副作用，并且可以成功地重新训练。应进行进一步的大型研究，以证实我们在癌症儿科患者中令人鼓舞的初步数据。
