一项针对肿瘤按摩治疗化疗引起的周围神经病变的随机先导研究。

A randomized pilot study of oncology massage to treat chemotherapy-induced peripheral neuropathy.

机构信息

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.

出版信息

Sci Rep. 2022 Nov 8;12(1):19023. doi: 10.1038/s41598-022-23372-w.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16fa/9643426/95a99748701c/41598_2022_23372_Fig1_HTML.jpg

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