Bienfait Florent, Julienne Arthur, Jubier-Hamon Sabrina, Seegers Valerie, Delorme Thierry, Jaoul Virginie, Pluchon Yves-Marie, Lebrec Nathalie, Dupoiron Denis
Anaesthesiology and Pain Department, Institut de Cancérologie de l'Ouest, 49100 Angers, France.
Biometrics Department, Institut de Cancérologie de l'Ouest, 49100 Angers, France.
Cancers (Basel). 2023 Jan 5;15(2):349. doi: 10.3390/cancers15020349.
Chemotherapy-induced peripheral neuropathy (CIPN) is often painful and can arise during or after the end of oncological treatments. They are mostly induced by platinum salts, taxanes, and immunotherapies. Their incidence is estimated between 19 and 85%. They can require a chemotherapy dose reduction or early termination. The European Society for Medical Oncology (ESMO) recommends high-concentration capsaicin patch (HCCP) in second line for the treatment of painful CIPN. This treatment induces a significative pain relief but only shown by low-powered studies. The objective of this study was to evaluate efficacy and tolerability of HCCP applications in CIPN. This monocentric observational retrospective real-world-data study of the CERCAN cohort took place in the Western Cancer Institute's Anaesthesiology and Pain Department at Angers, France. Independent pain physicians completed the CGIC (Clinician Global Impression of Change) for each patient who benefited from HCCP applications for painful CIPN starting from 1 January 2014 to 22 December 2021, based on the collected data after every patch application. A total of 57 patients (80.7% women) was treated with HCCP for painful CIPN, and 184 applications were realized, consisting of 296 sessions. CGIC found an important or complete pain relief for 61 applications (33.2%, corresponding to 43.9% patients). We found less efficacy for platinum-salts-induced CIPN compared to others ( = 0.0238). The efficacy was significatively higher for repeated applications when HCCP was used in second line compared to third line ( = 0.018). The efficacy of HCCP was significatively higher starting the third application ( = 0.0334). HCCPs were mainly responsible for local adverse events found in 66.6% patients (65.1% burning or painful sensation, 21.1% erythema). HCCP applications in painful CIPN induce an important pain relief with a global satisfying tolerability.
化疗引起的周围神经病变（CIPN）通常会引起疼痛，可在肿瘤治疗期间或结束后出现。它们大多由铂盐、紫杉烷和免疫疗法诱发。其发生率估计在19%至85%之间。它们可能需要减少化疗剂量或提前终止治疗。欧洲医学肿瘤学会（ESMO）推荐高浓度辣椒素贴剂（HCCP）用于二线治疗疼痛性CIPN。这种治疗可显著缓解疼痛，但仅在低效能研究中得到证实。本研究的目的是评估HCCP应用于CIPN的疗效和耐受性。这项对CERCAN队列进行的单中心观察性回顾性真实世界数据研究在法国昂热西部癌症研究所的麻醉学和疼痛科开展。独立的疼痛科医生根据2014年1月1日至2021年12月22日期间每次贴剂应用后收集的数据，为每一位受益于HCCP治疗疼痛性CIPN的患者完成临床医生总体变化印象（CGIC）评估。共有57例患者（80.7%为女性）接受了HCCP治疗疼痛性CIPN，共进行了184次应用，包括296个疗程。CGIC评估发现61次应用（33.2%，对应43.9%的患者）有显著或完全的疼痛缓解。我们发现与其他类型相比，铂盐诱发的CIPN疗效较差（P = 0.0238）。当HCCP用于二线治疗时，重复应用的疗效显著高于三线治疗（P = 0.018）。从第三次应用开始，HCCP的疗效显著更高（P = 0.0334）。HCCP主要导致局部不良事件，66.6%的患者出现此类情况（65.1%为烧灼感或疼痛感，21.1%为红斑）。HCCP应用于疼痛性CIPN可显著缓解疼痛，总体耐受性良好。
