Maschio Marta, Zarabla Alessia, Maialetti Andrea, Marchesi Francesco, Giannarelli Diana, Gumenyuk Svitlana, Pisani Francesco, Renzi Daniela, Galiè Edvina, Mengarelli Andrea
1 Center for Tumor-Related Epilepsy, UOSD Neurology, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
Integr Cancer Ther. 2018 Dec;17(4):1115-1124. doi: 10.1177/1534735418803758. Epub 2018 Oct 8.
Peripheral neuropathy is a common complication of chemotherapy that can induce marked disability that negatively affects the quality of life in patients with multiple myeloma (MM). The aim of this study was to prevent the onset or the worsening of peripheral neuropathy in MM patients treated with bortezomib (BTZ), using a new nutritional neuroprotective compound. We report preliminary results of 18 out of 33 patients who completed the study.
We administered a tablet of Neuronorm to patients, containing docosahexaenoic acid 400 mg, α-lipoic acid 600 mg, vitamin C 60 mg, and vitamin E 10 mg bid for the whole follow-up period. Neurological visit assessment, electroneurography, and evaluation scales were performed at baseline and after 6 months.
At 6 months, 8 patients had no chemotherapy-induced peripheral neuropathy, while 10 patients experienced chemotherapy-induced peripheral neuropathy of grade 1 according to the Common Terminology Criteria for Adverse Events, one of them with pain. Seventeen patients did not report painful symptoms; no limitation of functional autonomy and stability in quality of life domains explored was observed.
Our results seem to indicate that early introduction of a neuroprotective agent in our patients with MM treated with BTZ could prevent the onset or the worsening of neuropathic pain, avoiding the interruption of the therapy with BTZ, and maintaining a good functional autonomy to allow normal daily activities. Despite the limitations due to the fact that this is a preliminary study, in a small population, with short follow-up, our data seem to indicate that the nutraceutical may have some potential to be considered for a future trial.
周围神经病变是化疗常见的并发症，可导致严重残疾，对多发性骨髓瘤（MM）患者的生活质量产生负面影响。本研究旨在使用一种新型营养神经保护化合物，预防接受硼替佐米（BTZ）治疗的MM患者发生周围神经病变或使其病情恶化。我们报告了33例完成研究的患者中18例的初步结果。
在整个随访期间，我们给患者服用一片Neuronorm，其中含有400毫克二十二碳六烯酸、600毫克α-硫辛酸、60毫克维生素C和10毫克维生素E，每日两次。在基线和6个月后进行神经科访视评估、神经电图检查和评估量表测试。
6个月时，8例患者未发生化疗引起的周围神经病变，而根据不良事件通用术语标准，10例患者发生了1级化疗引起的周围神经病变，其中1例伴有疼痛。17例患者未报告疼痛症状；在所探索的生活质量领域中，未观察到功能自主性受限和稳定性问题。
我们的结果似乎表明，在接受BTZ治疗的MM患者中早期引入神经保护剂可预防神经性疼痛的发生或恶化，避免中断BTZ治疗，并保持良好的功能自主性以进行正常日常活动。尽管由于这是一项初步研究，样本量小且随访时间短存在局限性，但我们的数据似乎表明这种营养补充剂可能具有一定潜力，值得未来进行试验。
