Sassmann Robert, Gampenrieder Simon Peter, Rieder Florian, Johansson Tim, Rinnerthaler Gabriel, Castagnaviz Vanessa, Lampl Kathrin, Herfert Jürgen, Kienberger Yvonne Theres, Flamm Maria, Schaffler-Schaden Dagmar, Greil Richard
Institute of Physical Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria.
IIIrd Medical Department with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria.
Front Neurol. 2024 Dec 24;15:1451456. doi: 10.3389/fneur.2024.1451456. eCollection 2024.
Electrotherapy has been investigated in chronic pain and diabetic peripheral neuropathy, however prospective trials in patients with chemotherapy-induced peripheral neuropathy (CIPN) are scarce.
Fifty-one patients with CIPN ≥ grade 1 subsequent to receiving platinum- and/or taxane-based chemotherapy types were randomized to 8 weeks of high tone external muscle stimulation (HTEMS) or transcutaneous electrical nerve stimulation (TENS). The primary outcome were changes in the EORTC-QLQ-CIPN20 questionnaire. Secondary outcomes included clinical examinations, a classification of CIPN according to CTCAE v 4 and the EORTC-QLQ-C30 questionnaire. A control group (n = 17) receiving no intervention was recruited retrospectively.
The EORTC-QLQ-CIPN20 sensory and motor scales improved in both intervention groups (TENS: -12.3pts and - 8.2pts; HTEMS: -14.7pts and - 8.2pts) with no significant changes in the control group -3.3pts; -2.8pts. The changes in the sensory scale differed significantly between the HTEMS and the control group. In the EORTC-QLQ-C30 questionnaire, there was a significant improvement for physical functioning in the HTEMS group only (+7.9pts) with no between group differences. CIPN classification according to CTCAE v4 improved significantly in both intervention groups.
Home-based electrotherapy with HTEMS or TENS were successful in improving CIPN-related sensory impairment and could therefore provide a powerful treatment for this side-effect of chemotherapy.
电疗法已在慢性疼痛和糖尿病周围神经病变中得到研究，然而关于化疗引起的周围神经病变（CIPN）患者的前瞻性试验却很少。
51例在接受铂类和/或紫杉烷类化疗后CIPN≥1级的患者被随机分为两组，分别接受为期8周的高音调外部肌肉刺激（HTEMS）或经皮电神经刺激（TENS）。主要结局是欧洲癌症研究与治疗组织生活质量问卷CIPN20（EORTC-QLQ-CIPN20）的变化。次要结局包括临床检查、根据美国国立癌症研究所不良事件通用术语标准第4版（CTCAE v 4）对CIPN进行分类以及EORTC-QLQ-C30问卷。回顾性招募了一个未接受干预的对照组（n = 17）。
两个干预组（TENS组：-12.3分和-8.2分；HTEMS组：-14.7分和-8.2分）的EORTC-QLQ-CIPN20感觉和运动量表均有所改善，而对照组无显著变化（-3.3分；-2.8分）。HTEMS组与对照组的感觉量表变化存在显著差异。在EORTC-QLQ-C30问卷中，仅HTEMS组的身体功能有显著改善（+7.9分），组间无差异。两个干预组根据CTCAE v4进行的CIPN分类均有显著改善。
在家中进行的HTEMS或TENS电疗法成功改善了与CIPN相关的感觉障碍，因此可为化疗的这种副作用提供有效的治疗方法。
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