Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX, 77030, USA.
Division of Hematology and Oncology, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
Sci Rep. 2022 Nov 8;12(1):19023. doi: 10.1038/s41598-022-23372-w.
This pilot randomized controlled trial investigated massage therapy for symptomatic relief of chemotherapy-induced peripheral neuropathy (CIPN) to determine the ideal weekly frequency and number of weeks of providing massage. We evaluated the feasibility and initial efficacy of a Swedish massage protocol to treat lower extremity (LE) CIPN. Inclusion criteria: LE neuropathy attributed to oxaliplatin, paclitaxel, or docetaxel, with no other attributable causes; ≥ 6 months since last chemotherapy; self-reported neuropathy score ≥ 3, 0-10 scale; age ≥ 18. Participant randomization (2:2:1:1) to one of four groups: LE (2) or head/neck/shoulder (control; 1) massage 3 times (3X) a week for 4 weeks; LE (2) or control (1) massage 2X/week for 6 weeks. Completion rate and the Pain Quality Assessment Scale (PQAS) was measured at baseline and 10 weeks later. 71 patients participated: 77.5% women; 57.7% (breast cancer), and 42.3% (GI cancer); mean age 60.3 y/o (range: 40-77); average > 3 years since last chemotherapy. Massage was deemed feasible: mean completion rates (max = 12) were 8.9 (SD 4.2) for 3X/week and 9.8 (SD 4.0) for 2X/week with no statistically significant differences. There were no statistically significant treatment group interactions in PQAS scores at 10-weeks follow-up. There was a statistically significant treatment schedule main effect for PQAS subscales (p < 0.05) at 10 weeks, with lower CIPN symptoms for 3X/week groups versus 2X/week groups. Improvements considered clinically significant favored the LE 3X/week group. Completion rates met pre-defined feasibility criteria. We seemed to observe better outcomes (CIPN symptom reduction) with the more intensive (3X/week for 4 weeks) massage intervention with no differences in adherence, regardless of whether the massage was directly to the CIPN-affected area or not. However, there was some suggestion that the massage program targeting the CIPN-affected area directly provided 3X a week for 4 weeks resulted in the best outcomes.
这项初步随机对照试验研究了按摩疗法对化疗引起的周围神经病(CIPN)的症状缓解作用,以确定提供按摩的理想每周频率和周数。我们评估了瑞典式按摩方案治疗下肢(LE)CIPN 的可行性和初步疗效。纳入标准:归因于奥沙利铂、紫杉醇或多西他赛的 LE 神经病,无其他可归因原因;距末次化疗≥6 个月;自我报告的神经病评分≥3,0-10 分;年龄≥18 岁。参与者按 2:2:1:1 随机分配至以下四组之一:LE(2 例)或头/颈/肩部(对照组;1 例)按摩 3 次/周,共 4 周;LE(2 例)或对照组(1 例)按摩 2 次/周,共 6 周。在基线和 10 周后测量完成率和疼痛质量评估量表(PQAS)。71 例患者参加:女性占 77.5%(乳腺癌 57.7%,胃肠道癌 42.3%);平均年龄 60.3 岁(范围:40-77);末次化疗后平均≥3 年。按摩被认为是可行的:每周 3 次的平均完成率(最高 12 分)为 8.9(SD 4.2),每周 2 次的为 9.8(SD 4.0),无统计学差异。10 周随访时,PQAS 评分的治疗组间无统计学显著差异。10 周时,PQAS 各分量表的治疗方案主效应有统计学意义(p<0.05),每周 3 次组的 CIPN 症状低于每周 2 次组。考虑到临床显著改善,每周 3 次的 LE 组更有利。完成率符合预先定义的可行性标准。我们似乎观察到更密集的(4 周内每周 3 次)按摩干预(3X/week 组)的结局更好(CIPN 症状减轻),而无论按摩是否直接针对 CIPN 受累区域,其依从性均无差异。然而,有一些迹象表明,直接针对 CIPN 受累区域的按摩方案每周 3 次,持续 4 周,效果最佳。