From the Case Western Reserve University/MetroHealth, Cleveland, Ohio.
Am J Phys Med Rehabil. 2021 Apr 1;100(4):e52-e54. doi: 10.1097/PHM.0000000000001542.
Chemotherapy-induced neuropathy has limited treatment options, and conventional medications used to treat neuropathic pain often do not provide adequate pain relief for patients with a history of cancer. Neuromodulation such as dorsal root ganglion stimulation remains a treatment that has been studied for chronic painful conditions such as low back pain, pelvic pain, complex regional pain syndrome, and phantom limb pain. Dorsal root ganglion stimulation has been presented for treatment of chemotherapy-induced neuropathy, but with limited duration of follow-up. We present a case of pain resolution after placement of a dorsal root ganglion stimulation for persistent chemotherapy-induced neuropathy. Our patient developed burning pain and allodynia in both feet 3 mos into her chemotherapy regimen, with worsened symptoms after cessation of chemotherapy. After failure of conservative pharmacotherapies, a 7-day dorsal root ganglion stimulation trial was implanted, resulting in 100% pain relief. A dorsal root ganglion stimulation was then implanted permanently, and our patient reported continued resolution of symptoms at evaluation 3 yrs after placement. To the author's knowledge, this is the first case of sustained relief with dorsal root ganglion stimulation placement for chemotherapy-induced neuropathy and presents a treatment option that warrants further investigation.
化疗引起的周围神经病的治疗选择有限，用于治疗神经病理性疼痛的常规药物通常不能为有癌症病史的患者提供充分的疼痛缓解。神经调节，如背根神经节刺激，仍然是一种针对慢性疼痛病症的治疗方法，如腰痛、盆腔痛、复杂性区域疼痛综合征和幻肢痛。背根神经节刺激已被提出用于治疗化疗引起的周围神经病，但随访时间有限。我们报告了一例因持续化疗引起的周围神经病而放置背根神经节刺激后疼痛缓解的病例。我们的患者在化疗方案进行 3 个月后出现双脚烧灼感和感觉异常，化疗停止后症状恶化。在保守药物治疗失败后，植入了为期 7 天的背根神经节刺激试验，结果疼痛完全缓解。然后永久性植入背根神经节刺激器，我们的患者在放置后 3 年的评估中报告症状持续缓解。据作者所知，这是首例使用背根神经节刺激治疗化疗引起的周围神经病并获得持续缓解的病例，提出了一种值得进一步研究的治疗选择。
