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经皮外周神经刺激治疗化疗引起的神经病变:病例报告

Percutaneous Peripheral Nerve Stimulation in Chemotherapy-Induced Neuropathy: A Case Report.

作者信息

Mogedano-Cruz Sara, Romero-Morales Carlos, de la Cueva-Reguera Mónica, Campbell Kristin L, Herrero Pablo

机构信息

Department of Physiotherapy, Faculty of Medicine, Health and Sports, European University of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain.

Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.

出版信息

Reports (MDPI). 2025 Aug 1;8(3):133. doi: 10.3390/reports8030133.

DOI:10.3390/reports8030133
PMID:40843875
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12372149/
Abstract

: Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent and limiting complication of oncological treatment, particularly in patients receiving oxaliplatin. Its onset can significantly affect the quality of life and compromise the continuity of the antineoplastic therapy. Due to the limited efficacy of available pharmacological therapies, percutaneous electrical nerve stimulation (PENS) has been proposed as a non-invasive alternative for symptom management. : We report the case of a 75-year-old woman with colorectal adenocarcinoma who developed CIPN following oxaliplatin administration. She underwent a 12-week course of PENS targeting the median nerve, with weekly sessions conducted without interruption of chemotherapy and without adverse effects. The patient showed progressive improvement in neurosensory symptoms, as measured by the EORTC QLQ-CIPN20 questionnaire. Quantitative sensory testing revealed normalization of thermal and vibratory sensitivity and improved mechanical detection thresholds. The cumulative oxaliplatin dose was maintained throughout treatment. : PENS may offer an effective and safe therapeutic option for managing CIPN, enabling symptom control without compromising oncological treatment. This case supports the need for controlled clinical trials to confirm efficacy and establish standardized protocols.

摘要

化疗引起的周围神经病变(CIPN)是肿瘤治疗中常见的限制性并发症,尤其是在接受奥沙利铂治疗的患者中。其发作会显著影响生活质量并危及抗肿瘤治疗的连续性。由于现有药物治疗效果有限,经皮电神经刺激(PENS)已被提议作为一种用于症状管理的非侵入性替代方法。

我们报告了一例75岁患有结肠腺癌的女性患者,在接受奥沙利铂治疗后出现CIPN。她接受了为期12周的针对正中神经的PENS治疗,每周进行一次,化疗未中断且无不良反应。根据欧洲癌症研究与治疗组织QLQ-CIPN20问卷测量,患者的神经感觉症状逐渐改善。定量感觉测试显示热觉和振动觉敏感性恢复正常,机械检测阈值提高。整个治疗过程中奥沙利铂的累积剂量保持不变。

PENS可能为管理CIPN提供一种有效且安全的治疗选择,能够在不影响肿瘤治疗的情况下控制症状。该病例支持需要进行对照临床试验以确认疗效并建立标准化方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dbd/12372149/6ee3c5498d00/reports-08-00133-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dbd/12372149/276d06cc580b/reports-08-00133-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dbd/12372149/6ee3c5498d00/reports-08-00133-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dbd/12372149/276d06cc580b/reports-08-00133-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dbd/12372149/6ee3c5498d00/reports-08-00133-g002.jpg

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本文引用的文献

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Global estimates of prevalence of chronic painful neuropathy among patients with chemotherapy-induced peripheral neuropathy: systematic review and meta-analysis of data from 28 countries, 2000-24.化疗引起的周围神经病变患者中慢性疼痛性神经病变患病率的全球估计:对2000 - 2024年来自28个国家的数据进行的系统评价和荟萃分析
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Front Neurol. 2022 Jul 28;13:843886. doi: 10.3389/fneur.2022.843886. eCollection 2022.
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Ultrasound-Guided Median Nerve Electrical Stimulation to Promote Upper Limb Function Recovery after Stroke.超声引导下正中神经电刺激促进脑卒中后上肢功能恢复
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Neurotherapeutics. 2021 Oct;18(4):2384-2396. doi: 10.1007/s13311-021-01142-2. Epub 2021 Oct 21.
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