Acupoint Catgut Embedding at Stellate Ganglion Combined with Oral Mecobalamin Versus Mecobalamin Monotherapy in Managing Taxane-Induced Peripheral Neurotoxicity: A Clinical Observational Study.

PURPOSE

Taxane-induced peripheral neurotoxicity (TIPN) severely impacts the quality of life of patients and worsens over time with cumulative drug exposure. This study aims to evaluate the efficacy and safety of Stellate Ganglion Catgut Embedding (SGCE) therapy in treating TIPN patients, exploring a novel approach to managing TIPN.

PATIENTS AND METHODS

The study was conducted from June 2023 to June 2024 at the Second Affiliated Hospital of Harbin Medical University. Patients (at least two cycles of taxane treatment, including albumin-bound paclitaxel, paclitaxel, docetaxel, etc) were divided into methylcobalamin (MeCbl, n=25) and SGCE (n=21) groups. The former received oral methylcobalamin therapy, while the SGCE group underwent Stellate Ganglion Blockade with Catgut Implantation combined with oral methylcobalamin therapy. Neurotoxicity was assessed using the EORTC QLQ-CIPN15 and FACT/GOG-Ntx scales, with patient quality of life evaluated using the FACT-G scale. Comprehensive outcomes would be assessed on the day of treatment (SGCE or MeCbl treatment) and at the 1st and 3rd weeks post-treatment for all participants. Adverse events were assessed using the CTCAE scales.

RESULTS

The principal findings revealed that according to the EORTC QLQ-CIPN15 sensory, motor, overall scores and FACT/GOG-Ntx scale scores, there were significant decreases in the SGCE group compared to the MeCbl group after 3 weeks of treatment (<0.05). The secondary outcomes showed that the FACT-G scores in the SGCE group significantly increased from baseline ( =0.011). Throughout the assessment period before and after treatment, no significant adverse reactions were observed in the patients.

CONCLUSION

SGCE group produced a more pronounced improvement in symptoms among TIPN patients compared to MeCbl group, enhanced the quality of life of the patients compared with the pre-treatment period, this improvement could be linked to SGCE. Moreover, the patients did not show significant adverse effects.