Department of Anesthesiology & Critical Care Medicine, George Washington University Hospital, Washington, DC, U.S.A.
Anticancer Res. 2024 Jul;44(7):2769-2774. doi: 10.21873/anticanres.17088.
BACKGROUND/AIM: Chemotherapy-induced peripheral neuropathy (CIPN) continues to be a major source of chronic morbidity in patients with cancer. Current treatment options and efficacy are limited; thus, there is a need to investigate more effective therapeutic options. Spinal neuromodulation including dorsal column spinal cord stimulation (SCS) and dorsal root ganglion stimulation (DRG-S) are being explored for these patients. The purpose of this narrative review was to critically summarize and evaluate the advancements that have been made in utilizing SCS and DRG-S for CIPN.
A thorough literature search was conducted using PubMed for any research on patients with CIPN who underwent DRG-S or SCS. Studies involving patients with general cancer-related pain were not included. Only articles that were published in English, had original, extractable data, and were available on or before August 1, 2023, were included.
This study evaluated twelve studies with a total of 13 patients that reported using SCS for CIPN and four studies with a total of 12 patients that reported using DRG-S for CIPN. Many of the studies demonstrated that DRG-S or SCS can assist in reducing opioid consumption, lowering pain scores, and improving sensory deficits.
DRG-S and SCS have the potential to improve symptoms and lower medication usage in patients suffering from CIPN. Spinal neuromodulation could be considered as an alternative therapy for patients with persistent symptoms.
背景/目的:化疗引起的周围神经病(CIPN)仍然是癌症患者慢性发病的主要原因。目前的治疗选择和疗效有限;因此,需要研究更有效的治疗选择。脊髓神经调节,包括背柱脊髓刺激(SCS)和背根神经节刺激(DRG-S),正在为这些患者进行探索。本叙述性综述的目的是批判性地总结和评估在利用 SCS 和 DRG-S 治疗 CIPN 方面取得的进展。
使用 PubMed 对接受 DRG-S 或 SCS 治疗的 CIPN 患者进行了全面的文献检索。未包括涉及一般癌症相关疼痛患者的研究。仅包括以英文发表、具有可提取原始数据且在 2023 年 8 月 1 日或之前可获取的文章。
这项研究评估了 12 项共涉及 13 名患者使用 SCS 治疗 CIPN 的研究和 4 项共涉及 12 名患者使用 DRG-S 治疗 CIPN 的研究。许多研究表明,DRG-S 或 SCS 可以帮助减少阿片类药物的消耗、降低疼痛评分并改善感觉缺陷。
DRG-S 和 SCS 有可能改善 CIPN 患者的症状并降低药物使用量。对于持续存在症状的患者,脊髓神经调节可以被视为一种替代治疗方法。