University of Manitoba, Winnipeg, Manitoba, Canada.
CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Neurorehabil Neural Repair. 2020 Mar;34(3):235-246. doi: 10.1177/1545968319899918. Epub 2020 Jan 24.
. Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of taxane treatment and cannot currently be prevented or adequately treated. Physical therapy is often used for neural rehabilitation following injury but has not been evaluated in this patient population. . Single-blind, randomized controlled exploratory study compared standard care to a physical therapy home program (4 visits) throughout adjuvant taxane chemotherapy for stage I-III patients with breast cancer (n = 48). Patient questionnaires and quantitative sensory testing evaluated the treatment effect throughout chemotherapy to 6 months post treatment. Nonrandomized subgroup analysis observed effect of general exercise on sensory preservation comparing those reporting moderate exercise throughout chemotherapy to those that did not exercise regularly. . clinicaltrials.gov (NCT02239601). . The treatment group showed strong trends toward less pain (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.17-1.01; = .053) and pain decreased over time (OR 0.85, 95% CI 0.76-0.94; = .002). Pain pressure thresholds ( = .034) and grip dynamometry ( < .001) were improved in the treatment group. For the nonrandomized subgroup analysis, participants reporting general exercise had preservation of vibration (Left = .001, Right = .001) and normal heat pain thresholds (Left = .021, Right = .039) compared with more sedentary participants. . Physical therapy home program may improve CIPN pain in the upper extremity for patients with breast cancer, and general exercise throughout chemotherapy treatment was observed to have correlated to preservation of sensory function. Further research is required to confirm the impact of a physical therapy home program on CIPN symptoms.
. 化疗引起的周围神经病(CIPN)是紫杉烷治疗的常见副作用,目前无法预防或充分治疗。物理疗法常用于神经损伤后的康复,但尚未在该患者人群中进行评估。. 一项单盲、随机对照探索性研究比较了标准护理与物理治疗家庭方案(4 次就诊),该方案贯穿于 I-III 期乳腺癌患者的辅助紫杉烷化疗(n = 48)。患者问卷调查和定量感觉测试评估了整个化疗过程直至治疗后 6 个月的治疗效果。非随机亚组分析观察了常规运动对感觉保存的影响,比较了化疗期间报告适度运动与不经常运动的患者。. clinicaltrials.gov(NCT02239601)。. 治疗组疼痛明显减轻(优势比 [OR] 0.41,95%置信区间 [CI] 0.17-1.01; =.053),疼痛随时间推移而降低(OR 0.85,95% CI 0.76-0.94; =.002)。治疗组的疼痛压力阈值( =.034)和握力测力计( <.001)均有所改善。对于非随机亚组分析,报告常规运动的参与者与更久坐的参与者相比,振动保留(左侧 =.001,右侧 =.001)和正常热痛阈值(左侧 =.021,右侧 =.039)得到保留。. 家庭物理治疗方案可能改善乳腺癌患者上肢 CIPN 疼痛,且整个化疗期间的常规运动与感觉功能的保留相关。需要进一步的研究来确认家庭物理治疗方案对 CIPN 症状的影响。