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Eroğlu İ, Kutlutürkan S. The effect of hand-foot exercises on chemotherapy-induced peripheral neuropathy-related pain, falls, and quality of life in colorectal cancer: A randomized controlled trial. Eur J Oncol Nurs 2024; 71:102641. [PMID: 38897103 DOI: 10.1016/j.ejon.2024.102641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 05/29/2024] [Accepted: 06/14/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE The aim of this study is to determine the effect of hand-foot exercises on chemotherapy-induced peripheral neuropathy-related pain severity, falls, and quality of life in patients with colorectal cancer. METHODS The study was conducted in the outpatient chemotherapy unit of a public hospital between 25 April-31 December 2022. The enrolled 39 patients were randomly assigned to the intervention (n:19) and control (n:20) groups. The hand-foot exercises program was applied to the intervention group in three sessions a day and three days a week fashion for 8 weeks at home. No intervention was applied to the control group other than routine treatment and care. Data were collected through face-to-face interviews in the first interview and the 2nd, 4th, 6th, 8th weeks. The exercise program adherence of the intervention group was followed up through telephone/face-to-face interviews in weeks 1-8. Data were collected using the Numerical Pain Rating Scale, Fall Follow-Up Form, the CIPNAT scale, EORTC QLQ-C30 and EORTC QLQ-CR29 scales. Mann-Whitney U Test, Chi-square test, Wilcoxon signed test, and Friedman test were used to analyze the data. RESULTS The study found that as of week 4th, the intervention group experienced less pain severity than the control group (p < 0.001); at week 8th, the peripheral neuropathy symptoms of the intervention group decreased compared to the control group (p < 0.05); at weeks 2nd,4th,6th,8th, there was no statistically significant difference in falls (p > 0.05); at week 8th, while there was no significant difference between the groups regarding colorectal cancer quality of life (p > 0.05), the overall cancer quality of life improved in the intervention group (p < 0.05). CONCLUSIONS The hand-foot exercises program is effective in chemotherapy-induced peripheral neuropathy-related symptoms, pain severity, and overall cancer quality of life. TRIAL REGISTRATION www. CLINICALTRIALS gov, NCT05873829.
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Affiliation(s)
- İlayda Eroğlu
- Ankara University Nursing Faculty, Department of Internal Medicine Nursing, Ankara, Turkey.
| | - Sevinç Kutlutürkan
- Ankara University Nursing Faculty, Department of Internal Medicine Nursing, Ankara, Turkey.
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Balayssac D, Kerckhove N, Selvy M, Pereira B, Gonneau C, Pétorin C, Vimal-Baguet A, Melnikov S, Kullab S, Hebbar M, Bouché O, Slimano F, Bourgeois V, Lebrun-Ly V, Thuillier F, Mazard T, Tavan D, Benmammar KE, Monange B, Ramdani M, Péré-Vergé D, Huet-Penz F, Bedjaoui A, Genty F, Leyronnas C, Pezet D, Martin V. Motor disorders related to oxaliplatin-induced peripheral neuropathy: long-term severity and impact on quality of life. Support Care Cancer 2024; 32:427. [PMID: 38869647 DOI: 10.1007/s00520-024-08627-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/02/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE Sensory chemotherapy-induced peripheral neuropathy (CIPN) is well-recognized, but motor CIPN remains understudied. This secondary analysis focused on the long-term severity and impact of motor disorders, their relation to sensory CIPN, neuropathic pain, psychological distress, and health-related quality of life (HRQoL) after oxaliplatin-based chemotherapy in colorectal cancer (CRC) survivors. METHODS Data from a multicenter, cross-sectional study were re-analyzed to explore motor CIPN among CRC survivors up to 5 years post-chemotherapy, with no longitudinal follow-up. Questionnaires assessed sensory and motor CIPN (QLQ-CIPN20), neuropathic pain (DN4), anxiety and depression (HADS), and HRQoL (QLQ-C30). RESULTS Among 405 CRC survivors, 31.1% had sensory CIPN as previously described. When categorizing the 405 CRC survivors based on the years since their last oxaliplatin-based chemotherapy, the motor scores derived from the QLQ-CIPN20 showed no significant difference between years (p = 0.08). Motor CIPN scores correlated with female gender, higher oxaliplatin dose intensity, sensory CIPN, and neuropathic pain. Motor CIPN also linked to decreased HRQoL and increased psychological distress. CONCLUSION The study underscores the detrimental impact of motor disorders on CRC survivors post-oxaliplatin-based chemotherapy. Oncologists should prioritize assessing and managing motor manifestations alongside sensory symptoms to enhance post-cancer quality of life. TRIAL REGISTRATION NCT02970526 (2016-11-22). https://classic. CLINICALTRIALS gov/ct2/show/NCT02970526?term=NCT02970526&draw=2&rank=1 .
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Affiliation(s)
- David Balayssac
- INSERM U1107 NEURO-DOL, CHU Clermont-Ferrand, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France.
| | - Nicolas Kerckhove
- INSERM U1107 NEURO-DOL, CHU Clermont-Ferrand, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France
| | - Marie Selvy
- INSERM U1107 NEURO-DOL, CHU Clermont-Ferrand, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France
| | - Bruno Pereira
- Direction à la Recherche Clinique et de l'Innovation, CHU Clermont-Ferrand, F-63000, Clermont-Ferrand, France
| | - Coralie Gonneau
- INSERM U1107 NEURO-DOL, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France
| | - Caroline Pétorin
- Service Oncologie digestive, CHU Clermont-Ferrand, F-63000, Clermont-Ferrand, France
| | - Agnès Vimal-Baguet
- Service Oncologie digestive, CHU Clermont-Ferrand, F-63000, Clermont-Ferrand, France
| | - Sergey Melnikov
- Service Chirurgie générale et viscérale, Centre Hospitalier de Saint-Flour, F-15100, Saint-Flour, France
| | - Sharif Kullab
- Service Oncologie, Centre Hospitalier de Moulins Yzeure, F-03006, Moulins, France
| | | | - Olivier Bouché
- CHU Reims, Service Oncologie digestive, BioSpecT, Université de Reims Champagne-Ardenne, F-51100, Reims, France
| | - Florian Slimano
- CHU Reims, Service Pharmacie, BioSpecT, Université de Reims Champagne-Ardenne, EA n 7506, SFR CAP-Santé, F-51100, Reims, France
| | - Vincent Bourgeois
- Service Oncologie digestive, Centre Hospitalier de Boulogne sur Mer, F-62321, Boulogne-Sur-Merv, France
| | | | | | - Thibault Mazard
- IRCM, Inserm, ICM, Univ Montpellier, F-34298, Montpellier, France
| | - David Tavan
- Service Gastro-entérologie, Infirmerie Protestante de Lyon, F-69300, Caluire et Cuire, France
| | | | - Brigitte Monange
- Service Oncologie, Centre Hospitalier Emile Roux, F-43000, Le Puy-en-Velay, France
| | - Mohamed Ramdani
- Service Gastro-entérologie, Centre Hospitalier de Béziers, F-34500, Béziers, France
| | - Denis Péré-Vergé
- Service Hépato-gastro-entérologie, Centre Hospitalier Saint-Joseph Saint-Luc, F-69007, Lyon, France
| | - Floriane Huet-Penz
- Service Gastro entérologie, Centre Hospitalier Alpes Leman, F-74130, Contamine sur Arve, France
| | - Ahmed Bedjaoui
- Service Gastro-entérologie, Centre hospitalier Intercommunal Les Hôpitaux du Léman, F-74203, Thonon les bains, France
| | - Florent Genty
- Service Chirurgie digestive et viscérale, Centre Hospitalier de Vichy, F-03200, Vichy, France
| | - Cécile Leyronnas
- Groupe Hospitalier Mutualiste de Grenoble, Service Oncologie, F-38000, Grenoble, France
| | - Denis Pezet
- UFRs de Médecine et de Pharmacie, INSERM U1071, M2iSH, USC-INRA 2018, CHU Clermont-Ferrand, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France
| | - Vincent Martin
- AME2P, Clermont-Ferrand, Institut Universitaire de France (IUF), Université Clermont Auvergne, F-63000, Paris, France
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Albin B, Adhikari P, Tiwari AP, Qubbaj K, Yang IH. Electrical stimulation enhances mitochondrial trafficking as a neuroprotective mechanism against chemotherapy-induced peripheral neuropathy. iScience 2024; 27:109052. [PMID: 38375222 PMCID: PMC10875116 DOI: 10.1016/j.isci.2024.109052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/20/2023] [Accepted: 01/23/2024] [Indexed: 02/21/2024] Open
Abstract
Electrical stimulation (ESTIM) has shown to be an effective symptomatic treatment to treat pain associated with peripheral nerve damage. However, the neuroprotective mechanism of ESTIM on peripheral neuropathies is still unknown. In this study, we identified that ESTIM has the ability to enhance mitochondrial trafficking as a neuroprotective mechanism against chemotherapy-induced peripheral neuropathies (CIPNs). CIPN is a debilitating and painful sequalae of anti-cancer chemotherapy treatment which results in degeneration of peripheral nerves. Mitochondrial dynamics were analyzed within axons in response to two different antineoplastic mechanisms by chemotherapy drug treatments paclitaxel and oxaliplatin in vitro. Mitochondrial trafficking response to chemotherapy drug treatment was observed to decrease in conjunction with degeneration of distal axons. Using low-frequency ESTIM, we observed enhanced mitochondrial trafficking to be a neuroprotective mechanism against CIPN. This study confirms ESTIM enhances regeneration of peripheral nerves by increased mitochondrial trafficking.
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Affiliation(s)
- Bayne Albin
- Center for Biomedical Engineering and Science, Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA
| | - Prashant Adhikari
- Center for Biomedical Engineering and Science, Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA
| | - Arjun Prasad Tiwari
- Center for Biomedical Engineering and Science, Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA
| | - Khayzaran Qubbaj
- Center for Biomedical Engineering and Science, Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA
| | - In Hong Yang
- Center for Biomedical Engineering and Science, Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA
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Dinh PC, Monahan PO, Fosså SD, Sesso HD, Feldman DR, Dolan ME, Nevel K, Kincaid J, Vaughn DJ, Martin NE, Sanchez VA, Einhorn LH, Frisina R, Fung C, Kroenke K, Travis LB. Impact of pain and adverse health outcomes on long-term US testicular cancer survivors. J Natl Cancer Inst 2024; 116:455-467. [PMID: 37966940 PMCID: PMC10919346 DOI: 10.1093/jnci/djad236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND No study has quantified the impact of pain and other adverse health outcomes on global physical and mental health in long-term US testicular cancer survivors or evaluated patient-reported functional impairment due to pain. METHODS Testicular cancer survivors given cisplatin-based chemotherapy completed validated surveys, including Patient-Reported Outcomes Measurement Information System v1.2 global physical and mental health, Patient-Reported Outcomes Measurement Information System pain questionnaires, and others. Multivariable linear regression examined relationships between 25 adverse health outcomes with global physical and mental health and pain-interference scores. Adverse health outcomes with a β^ of more than 2 are clinically important and reported below. RESULTS Among 358 testicular cancer survivors (median age = 46 years, interquartile range [IQR] = 38-53 years; median time since chemotherapy = 10.7 years, IQR = 7.2-16.0 years), median adverse health outcomes number was 5 (IQR = 3-7). A total of 12% testicular cancer survivors had 10 or more adverse health outcomes, and 19% reported chemotherapy-induced neuropathic pain. Increasing adverse health outcome numbers were associated with decreases in physical and mental health (P < .0001 each). In multivariable analyses, chemotherapy-induced neuropathic pain (β^ = -3.72; P = .001), diabetes (β^ = -4.41; P = .037), obesity (β^ = -2.01; P = .036), and fatigue (β^ = -8.58; P < .0001) were associated with worse global mental health, while being married or living as married benefited global mental health (β^ = 3.63; P = .0006). Risk factors for pain-related functional impairment included lower extremity location (β^ = 2.15; P = .04) and concomitant peripheral artery disease (β^ = 4.68; P < .001). Global physical health score reductions were associated with diabetes (β^ = -3.81; P = .012), balance or equilibrium problems (β^ = -3.82; P = .003), cognitive dysfunction (β^ = -4.43; P < .0001), obesity (β^ = -3.09; P < .0001), peripheral neuropathy score (β^ = -2.12; P < .0001), and depression (β^ = -3.17; P < .0001). CONCLUSIONS Testicular cancer survivors suffer adverse health outcomes that negatively impact long-term global mental health, global physical health, and pain-related functional status. Clinically important factors associated with worse physical and mental health identify testicular cancer survivors requiring closer monitoring, counseling, and interventions. Chemotherapy-induced neuropathic pain must be addressed, given its detrimental impact on patient-reported functional status and mental health 10 or more years after treatment.
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Affiliation(s)
- Paul C Dinh
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Patrick O Monahan
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA
| | - Sophie D Fosså
- Department of Oncology, Oslo University Hospital, Radiumhospital, Oslo, Norway
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine Research, Brigham and Women’s Hospital, Boston, MA, USA
| | - Darren R Feldman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - M Eileen Dolan
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Kathryn Nevel
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - John Kincaid
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - David J Vaughn
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Neil E Martin
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Victoria A Sanchez
- Department of Medical Engineering, University of South Florida, Tampa, FL, USA
| | - Lawrence H Einhorn
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert Frisina
- Department of Medical Engineering, University of South Florida, Tampa, FL, USA
| | - Chunkit Fung
- Department of Medicine, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Kurt Kroenke
- Regenstrief Institute, Inc, Indiana University, Indianapolis, IN, USA
| | - Lois B Travis
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Araldi D, Khomula EV, Bonet IJM, Bogen O, Green PG, Levine JD. Role of pattern recognition receptors in chemotherapy-induced neuropathic pain. Brain 2024; 147:1025-1042. [PMID: 37787114 PMCID: PMC10907096 DOI: 10.1093/brain/awad339] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/25/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023] Open
Abstract
Progress in the development of effective chemotherapy is producing a growing population of patients with acute and chronic painful chemotherapy-induced peripheral neuropathy (CIPN), a serious treatment-limiting side effect for which there is currently no US Food and Drug Administration-approved treatment. CIPNs induced by diverse classes of chemotherapy drugs have remarkably similar clinical presentations, leading to the suggestion they share underlying mechanisms. Sensory neurons share with immune cells the ability to detect damage associated molecular patterns (DAMPs), molecules produced by diverse cell types in response to cellular stress and injury, including by chemotherapy drugs. DAMPs, in turn, are ligands for pattern recognition receptors (PRRs), several of which are found on sensory neurons, as well as satellite cells, and cells of the immune system. In the present experiments, we evaluated the role of two PRRs, TLR4 and RAGE, present in dorsal root ganglion (DRG), in CIPN. Antisense (AS)-oligodeoxynucleotides (ODN) against TLR4 and RAGE mRNA were administered intrathecally before ('prevention protocol') or 3 days after ('reversal protocol') the last administration of each of three chemotherapy drugs that treat cancer by different mechanisms (oxaliplatin, paclitaxel and bortezomib). TLR4 and RAGE AS-ODN prevented the development of CIPN induced by all three chemotherapy drugs. In the reversal protocol, however, while TLR4 AS-ODN completely reversed oxaliplatin- and paclitaxel-induced CIPN, in rats with bortezomib-induced CIPN it only produced a temporary attenuation. RAGE AS-ODN, in contrast, reversed CIPN induced by all three chemotherapy drugs. When a TLR4 antagonist was administered intradermally to the peripheral nociceptor terminal, it did not affect CIPN induced by any of the chemotherapy drugs. However, when administered intrathecally, to the central terminal, it attenuated hyperalgesia induced by all three chemotherapy drugs, compatible with a role of TLR4 in neurotransmission at the central terminal but not sensory transduction at the peripheral terminal. Finally, since it has been established that cultured DRG neurons can be used to study direct effects of chemotherapy on nociceptors, we also evaluated the role of TLR4 in CIPN at the cellular level, using patch-clamp electrophysiology in DRG neurons cultured from control and chemotherapy-treated rats. We found that increased excitability of small-diameter DRG neurons induced by in vivo and in vitro exposure to oxaliplatin is TLR4-dependent. Our findings suggest that in addition to the established contribution of PRR-dependent neuroimmune mechanisms, PRRs in DRG cells also have an important role in CIPN.
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Affiliation(s)
- Dionéia Araldi
- Department of Oral and Maxillofacial Surgery, UCSF Pain and Addiction Research Center, University of California at San Francisco, San Francisco, CA 94143, USA
| | - Eugen V Khomula
- Department of Oral and Maxillofacial Surgery, UCSF Pain and Addiction Research Center, University of California at San Francisco, San Francisco, CA 94143, USA
| | - Ivan J M Bonet
- Department of Oral and Maxillofacial Surgery, UCSF Pain and Addiction Research Center, University of California at San Francisco, San Francisco, CA 94143, USA
| | - Oliver Bogen
- Department of Oral and Maxillofacial Surgery, UCSF Pain and Addiction Research Center, University of California at San Francisco, San Francisco, CA 94143, USA
| | - Paul G Green
- Department of Oral and Maxillofacial Surgery, UCSF Pain and Addiction Research Center, University of California at San Francisco, San Francisco, CA 94143, USA
- Department of Preventative and Restorative Dental Sciences, Division of Neuroscience, University of California at San Francisco, San Francisco, CA 94143, USA
| | - Jon D Levine
- Department of Oral and Maxillofacial Surgery, UCSF Pain and Addiction Research Center, University of California at San Francisco, San Francisco, CA 94143, USA
- Department of Medicine, Division of Neuroscience, University of California at San Francisco, San Francisco, CA 94143, USA
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Li W, Xiao L, Yu ZQ, Li M, Wang XM, Liu D, Zhang CL. Attention and Intervention of Oncologists on Oxaliplatin-induced Adverse Reactions in Mainland China: A Cross-sectional Internet-based Survey. Curr Med Sci 2022; 42:1319-1324. [PMID: 36245029 DOI: 10.1007/s11596-022-2634-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/28/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This cross-sectional study aimed to investigate the current attention and intervention of oncologists on oxaliplatin (OXA)-induced adverse reactions (ADRs). METHODS In 31 provinces or administrative regions across China, 401 oncologists were surveyed through a self-designed questionnaire. The survey queried the basic information of respondents, clinical use of OXA, OXA-induced ADRs, and relative interventions. Chi-square tests and multiple logistic regression were used to explore the sociodemographic factors influencing the safety perception of OXA and the relevant interventions. RESULTS The survey showed that the age of respondents was mainly distributed between 30 and 40 years and the working period for most oncologists was no more than 5 years. Oncologists with long working years were more willing to conduct patient education and inquire about ADRs than those with short working years. The rate of ADRs reported by oncologists with intermediate professional titles was significantly higher than that reported by oncologists with junior and senior professional titles. CONCLUSION Our findings indicate that oncologists in mainland China are concerned about OXA-induced ADRs, but the reporting of ADRs still needs to be strengthened. Therefore, training and educational programs are urgently needed to improve the risk management of OXA-induced ADRs among oncologists.
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Affiliation(s)
- Wei Li
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lu Xiao
- Rehabilitation Division, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zao-Qin Yu
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Min Li
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xi-Min Wang
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dong Liu
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Cheng-Liang Zhang
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Temporal, Location- and Symptom-Specific Likelihood of Patient-Reported Sensory Symptoms Related to Oxaliplatin-Induced Peripheral Neuropathy (OIPN) in Patients Receiving Oxaliplatin for Three Months. Cancers (Basel) 2022; 14:cancers14051212. [PMID: 35267520 PMCID: PMC8909760 DOI: 10.3390/cancers14051212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 02/05/2023] Open
Abstract
While oxaliplatin-induced peripheral neuropathy (OIPN) is more common and severe in patients who receive the previous standard, 6-month oxaliplatin-based treatment, we hypothesized that OIPN was still pervasive in patients who received shorter, 3-month-treatment regimens. Using six EORTC QLQ-CIPN20 questions that quantify numbness (N), tingling (T) and shooting/burning pain (P) in upper/lower distal extremities, our aim is to quantify patient-reported responses over 3 months (6 cycles) of oxaliplatin regarding symptom-specific timing, location and severity. For each question, patients were asked how each of the sensory symptoms had affected them during the preceding week, with 1 = “Not at all”, 2 = “A little”, 3 = “Quite a bit” and 4 = “Very much”. The proportional odds model for the cumulative log odds of response that allowed symptom-specific patient heterogeneity to be obtained was applied to a pooled dataset from the placebo arms of two multisite OIPN prevention trials and fit separately to the upper/lower distal extremities. For each symptom, we report the cycle-specific marginal probabilities for each response. In 141 patients, substantial patient heterogeneity in the likelihood, at a given cycle, of a more severe response for a symptom was present. Distinct patterns in the probabilities for each response over time for N and T were observed between the upper/lower distal extremities, while the probabilities of a response >1 for P was largely negligible in both locations. Despite the decrease in exposure to oxaliplatin from 6 to 3 months, OIPN was still pervasive with patients experiencing considerable N and T in the fingers (or hands) and toes (or feet).
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Trompetter HR, Bonhof CS, van de Poll-Franse LV, Vreugdenhil G, Mols F. Exploring the relationship among dispositional optimism, health-related quality of life, and CIPN severity among colorectal cancer patients with chronic peripheral neuropathy. Support Care Cancer 2021; 30:95-104. [PMID: 34232392 PMCID: PMC8636445 DOI: 10.1007/s00520-021-06352-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/08/2021] [Indexed: 02/07/2023]
Abstract
Purpose Chemotherapy-induced peripheral neuropathy ((CI)PN) becomes chronic in 30% of cancer patients. Knowledge of predictors of chronic (CI)PN and related impairments in health-related quality of life (HRQoL) is lacking. We examined the role of optimism in chronic (CI)PN severity and associated HRQoL in colorectal cancer (CRC) patients up to two years after diagnosis. Methods CRC patients from a prospective cohort study participated, with sensory peripheral neuropathy (SPN) 1 year after diagnosis (n = 142). Multivariable regression analyses examined the cross-sectional association between optimism (measured by the LOT-R) and SPN severity/HRQoL (measured by the EORTC QLQ-CIPN20 and QLQ-C30), as well as the prospective association in a subsample that completed measures 2 years after diagnosis and still experienced SPN (n = 86). Results At 1-year follow-up, higher optimism was associated with better global HRQoL, and better physical, role, emotional, cognitive, and social functioning (all p < .01). Optimism at year one was also prospectively associated with better global HRQoL (p < .05), and emotional and cognitive functioning at 2-year follow-up (both p < .01). Optimism was not related to self-reported SPN severity. Significant associations were retained when controlling for demographic/clinical variables, and became non-significant after controlling for depressive and anxiety symptoms. Conclusions Optimism and depressive and anxiety symptoms are associated with HRQoL in CRC patients with chronic (CI)PN. Future research may illuminate the mechanisms that these factors share, like the use of (non)adaptive coping styles such as avoidance and acceptance that may inform the design of targeted interventions to help patients to adapt to chronic (CI)PN.
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Affiliation(s)
- Hester R Trompetter
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands.
| | - Cynthia S Bonhof
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Lonneke V van de Poll-Franse
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Gerard Vreugdenhil
- Department of Internal Medicine, Máxima Medical Centre, Eindhoven and Veldhoven, The Netherlands
| | - Floortje Mols
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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Peripheral Neuropathy under Oncologic Therapies: A Literature Review on Pathogenetic Mechanisms. Int J Mol Sci 2021; 22:ijms22041980. [PMID: 33671327 PMCID: PMC7922628 DOI: 10.3390/ijms22041980] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/05/2021] [Accepted: 02/07/2021] [Indexed: 02/06/2023] Open
Abstract
Peripheral neurologic complications are frequent adverse events during oncologic treatments and often lead to dose reduction, administration delays with time elongation of the therapeutic plan and, not least, worsening of patients’ quality of life. Experience skills are required to recognize symptoms and clinical evidences and the collaboration between different health professionals, in particular oncologists and hospital pharmacists, grants a correct management of this undesirable occurrence. Some classes of drugs (platinates, vinca alkaloids, taxanes) typically develop this kind of side effect, but the genesis of chemotherapy-induced peripheral neuropathy is not linked to a single mechanism. This paper aims from one side at summarizing and explaining all the scattering mechanisms of chemotherapy-induced peripheral neuropathy through a detailed literature revision, on the other side at finding new approaches to possible treatments, in order to facilitate the collaboration between oncologists, hematologists and hospital pharmacists.
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Shaheen NA, Alqahtani M, Alawbthani NS, Thomas A, Alaskar A. Chemotherapy-Induced Peripheral Neuropathy and its Impact on Health-Related Quality of Life among Multiple Myeloma Patients: A Single-Center Experience. Indian J Palliat Care 2020; 26:506-511. [PMID: 33623313 PMCID: PMC7888416 DOI: 10.4103/ijpc.ijpc_233_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/26/2020] [Accepted: 03/31/2020] [Indexed: 11/04/2022] Open
Abstract
Aim Chemotherapy-induced peripheral neuropathy (CIPN) is a long-term neurological health issue in patients diagnosed with multiple myeloma (MM). The aim of this study was to assess CIPN symptoms and health-related quality of life (HRQOL) among MM patients. Methods A cross-sectional survey was conducted among patients diagnosed with MM in a tertiary care hospital using a self-reported Arabic questionnaire, European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire for CIPN scale (QLQ-CIPN20). The HRQOL was assessed using EORTC multiple myeloma module (QLQ-MY20). Categorical variables were reported in frequency tables and percentages. Age and duration of MM diagnosis were reported as mean and standard deviation. Survey responses were presented using descriptive statistics. Results In total, 62 patients had participated. Males were 60%. The average age was 58.74 ± 11.49 years. On sensory scale, 20% reported "quite a bit"/"very much" tingling in fingers/hands, 23% in toes/feet, 39% numbness in fingers/hands, 37% in toes/feet, and 43% reported trouble standing or walking. On motor scale, 40% reported trouble walking and 60% had difficulty in climbing stairs/standing up from chair. On autonomic scale, 27% reported orthostatic hypotension and only 13/37 (46%) males reported erectile dysfunction. For HRQOL, 50% reported bone aches/pain, 42% reported back pain, 57% reported feeling ill, 33% reported lost hair, 35% had been thinking about their illness, whereas 28% were worried about future health and 22% had reported being worried about dying. Conclusion MM patients encounter CIPN symptoms with impaired HRQOL. Capturing CIPN as a patient-reported outcome needs to be considered in routine clinical practice.
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Affiliation(s)
- Naila A Shaheen
- Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Maha Alqahtani
- Princess Nourah bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Nada S Alawbthani
- Princess Nourah bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Abin Thomas
- Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed Alaskar
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.,Division of Adult Hematology and SCT, King Abdul-Aziz Medical City, Riyadh, Kingdom of Saudi Arabia
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Sarısoy P, Ovayolu O. The Effect of Foot Massage on Peripheral Neuropathy-Related Pain and Sleep Quality in Patients With Non-Hodgkin's Lymphoma. Holist Nurs Pract 2020; 34:345-355. [PMID: 33060497 DOI: 10.1097/hnp.0000000000000412] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study, which was conducted on patients with non-Hodgkin's lymphoma, aimed to evaluate the effect of foot massage on peripheral neuropathic pain and sleep quality. The survey was conducted between November 2018 and April 2019. Research data were collected through questionnaire, visual analogue scale (VAS), Douleur Neuropathique 4/Neuropathic Pain 4 (DN4) Questions, and Pittsburgh Sleep Quality Index. Classical foot massage was applied to participants in the intervention group, and they received 3 sessions a week, with each session lasting for 20 minutes over a period 4 weeks. After each massage session, pain levels were again assessed using the VAS and DN4 questionnaires. It has been shown that foot massage intervention reduces the patients' pain levels and has a positive effect on their sleep quality. Accordingly, foot massage can be recommended to patients with non-Hodgkin's lymphoma to reduce their peripheral neuropathy-related pain and improve their sleep quality.
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Affiliation(s)
- Pınar Sarısoy
- Gaziantep University Hospital, Gaziantep, Turkey (Ms Sarısoy); and Department of Nursing, Faculty of Health Science, Gaziantep University, Gaziantep, Turkey (Dr Ovayolu)
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Cisplatin-associated neuropathy characteristics compared with those associated with other neurotoxic chemotherapy agents (Alliance A151724). Support Care Cancer 2020; 29:833-840. [PMID: 32500206 DOI: 10.1007/s00520-020-05543-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/19/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE The current project was developed to obtain natural history information regarding cisplatin-induced peripheral neuropathy in males with testicular/germ cell cancers and to compare such neuropathy data with similarly obtained data in patients receiving other chemotherapy drugs in similarly conducted clinical trials. METHODS Patients without baseline neuropathy symptoms, who were initiating cisplatin-based chemotherapy, completed the EORTC CIPN 20 patient-reported instrument to evaluate chemotherapy-induced peripheral neuropathy (CIPN). Results were compared with EORTC CIPN 20 data obtained from independent study sets regarding patients receiving (1) paclitaxel, (2) combined paclitaxel and carboplatin, (3) oxaliplatin, or (4) a combination of doxorubicin and cyclophosphamide (AC). The last study set of patients on AC was selected to evaluate the use of EORTC CIPN 20 data in patients receiving chemotherapy not known to cause CIPN. RESULTS Cisplatin-induced neuropathy was more similar to neuropathy in patients receiving oxaliplatin than in those receiving paclitaxel. The cisplatin and oxaliplatin groups exhibited the coasting phenomenon and more prominent upper extremity symptoms than lower extremity symptoms during chemotherapy administration weeks. In contrast, paclitaxel-treated patients did not, on average, exhibit the coasting phenomenon; additionally, lower extremity symptoms were more prominent during the weeks when paclitaxel was administered. Cisplatin-induced neuropathy was less severe than was seen in patients in the other two groups, potentially because the cisplatin-receiving patients were younger. Patients receiving AC did not report substantial EORTC CIPN 20 changes. CONCLUSION Understanding neuropathy similarities and differences with various chemotherapy agents may help elucidate CIPN processes and facilitate means to prevent and/or treat established CIPN. TRIAL REGISTRATION NCT02677727.
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Staff NP, Cavaletti G, Islam B, Lustberg M, Psimaras D, Tamburin S. Platinum-induced peripheral neurotoxicity: From pathogenesis to treatment. J Peripher Nerv Syst 2020; 24 Suppl 2:S26-S39. [PMID: 31647151 DOI: 10.1111/jns.12335] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/15/2019] [Indexed: 12/17/2022]
Abstract
Platinum-induced peripheral neurotoxicity (PIPN) is a common side effect of platinum-based chemotherapy that may cause dose reduction and discontinuation, with oxaliplatin being more neurotoxic. PIPN includes acute neurotoxicity restricted to oxaliplatin, and chronic non-length-dependent sensory neuronopathy with positive and negative sensory symptoms and neuropathic pain in both upper and lower limbs. Chronic sensory axonal neuropathy manifesting as stocking-and-glove distribution is also frequent. Worsening of neuropathic symptoms after completing the last chemotherapy course may occur. Motor and autonomic involvement is uncommon. Ototoxicity is frequent in children and more commonly to cisplatin. Platinum-based compounds result in more prolonged neuropathic symptoms in comparison to other chemotherapy agents. Patient reported outcomes questionnaires, clinical evaluation and instrumental tools offer complementary information in PIPN. Electrodiagnostic features include diffusely reduced/abolished sensory action potentials, in keeping with a sensory neuronopathy. PIPN is dependent on cumulative dose but there is a large variability in its occurrence. The search for additional risk factors for PIPN has thus far yielded no consistent findings. There are currently no neuroprotective strategies to reduce the risk of PIPN, and symptomatic treatment is limited to duloxetine that was found effective in a single phase III intervention study. This review critically examines the pathogenesis, incidence, risk factors (both clinical and pharmacogenetic), clinical phenotype and management of PIPN.
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Affiliation(s)
- Nathan P Staff
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Guido Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Badrul Islam
- Laboratory Sciences and Services Division, The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Maryam Lustberg
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | - Dimitri Psimaras
- OncoNeuroTox Group, Center for Patients with Neurological Complications of Oncologic Treatments, Hôpitaux Universitaires Pitié-Salpetrière-Charles Foix et Hôpital Percy, Paris, France
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Avci IA, Altay B, Cavusoglu F, Cal A, Mumcu N, Eren DC, Oz O, Altin A, Karaoglanoglu O, Buberci A. Evaluation of the Efficacy of the Three-Component Health Care Management Program HEWCOT in Colorectal Cancer Patients Receiving Chemotherapy. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:274-283. [PMID: 30604384 DOI: 10.1007/s13187-018-1461-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study was performed to evaluate effects of education, home visits, web, and phone counseling on chemotherapy symptoms and anxiety in patients with colorectal cancer receiving chemotherapy. This pretest-posttest, quasi-experimental study was conducted in a chemotherapy unit of a hospital between February 2014 and October 2015. Due to dropouts from the study, was completed on 51 participants in the control group and 31 participants in the experimental group. The experimental group was offered a program that includes home visit, nursing education, web counseling, and tele-counseling (HEWCOT), developed by the researchers, to control symptoms and to reduce anxiety. The experimental group less frequently experienced constipation, pain, pricking and numbness in hands and feet, skin and nail problems, ocular problems, weakness, headache, mouth and throat problems, anxiety, and restlessness than the control group. The experimental group had less severe infection symptoms, hair loss, and mouth and throat problems after the interventions than the control group. In this study, the patients followed at home and provided web counseling and tele-counseling experienced less frequently chemotherapy symptoms.
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Affiliation(s)
- Iknur Aydin Avci
- Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Birsen Altay
- Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Figen Cavusoglu
- Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Ayse Cal
- Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey.
| | - Nuran Mumcu
- Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Dilek Celik Eren
- Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Ozge Oz
- Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Alaattin Altin
- Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Ozden Karaoglanoglu
- Samsun Education and Research Hospital Radiation Oncology Clinic, Samsun, Turkey
| | - Ayse Buberci
- Samsun Education and Research Hospital Chemotherapy Clinic, Samsun, Turkey
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Matsumoto Y, Yoshida Y, Kiba S, Yamashiro S, Nogami H, Ohashi N, Kajitani R, Munechika T, Nagano H, Komono A, Aisu N, Yoshimatsu G, Hasegawa S. Acute chemotherapy-induced peripheral neuropathy due to oxaliplatin administration without cold stimulation. Support Care Cancer 2020; 28:5405-5410. [PMID: 32144582 DOI: 10.1007/s00520-020-05387-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 02/26/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The incidence and time of onset of acute chemotherapy-induced peripheral neuropathy (ACIPN) caused by oxaliplatin remain unclarified. Hence, we investigated the prevalence, onset time, and location of ACIPN symptoms in patients with colorectal cancer (CRC) receiving oxaliplatin without cold stimulation. METHODS The study cohort comprised patients receiving oxaliplatin for CRC at our hospital between April 2017 and August 2018. Patients were instructed not to touch and/or drink cold things and were monitored for ACIPN symptoms in the hospital for 24 h after chemotherapy. ACIPN symptoms that appeared > 24 h after chemotherapy were recorded at the next visit. Symptom appearance time was defined as the duration from the administration of chemotherapy until the appearance of paresthesia classified as grade 1 using the Common Terminology Criteria for Adverse Events. RESULTS Forty-five patients received chemotherapy, comprising 23 men and 22 women, aged 67 years (29-88 years). The location of ACIPN was the fingers in 55.6% of cases, pharynx in 26.7%, perioral region in 24.4%, and feet in 6.7%. The average duration from oxaliplatin administration to symptom development was 182 min (range 62-443 min) for the fingers, 291 min (176-432 min) for the pharynx, 311 min (127-494 min) for the perioral region, and 297 min (234-355 min) for the feet. Pharyngeal symptoms were more common in patients older than 65 years than in those younger than 65 years. CONCLUSIONS The incidence and time of the onset of ACIPN caused by oxaliplatin varies between the body and regions.
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Affiliation(s)
- Yoshiko Matsumoto
- Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Yoichiro Yoshida
- Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan.
| | - Sachiko Kiba
- Nursing Department, Fukuoka University Hospital, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Shizuka Yamashiro
- Nursing Department, Fukuoka University Hospital, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Haruka Nogami
- Nursing Department, Fukuoka University Hospital, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Noriko Ohashi
- Nursing Department, Fukuoka University Hospital, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Ryuji Kajitani
- Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Taro Munechika
- Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Hideki Nagano
- Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Akira Komono
- Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Naoya Aisu
- Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Gumpei Yoshimatsu
- Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Suguru Hasegawa
- Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan
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Effect of Aromatherapy Massage on Chemotherapy-Induced Peripheral Neuropathic Pain and Fatigue in Patients Receiving Oxaliplatin: An Open Label Quasi-Randomized Controlled Pilot Study. Cancer Nurs 2020; 42:139-147. [PMID: 29200001 DOI: 10.1097/ncc.0000000000000577] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Patients receiving oxaliplatin may experience peripheral neuropathic pain and fatigue. Aromatherapy massage, a nonpharmacological method, may help to control these symptoms. OBJECTIVE The aim of this open-label, parallel-group, quasi-randomized controlled pilot study was to investigate the effect of aromatherapy massage on chemotherapy-induced peripheral neuropathic pain and fatigue in patients receiving oxaliplatin. METHODS Stratified randomization was used to allocate 46 patients to 2 groups: intervention (n = 22) and control (n = 24). Between week 1 and week 6, participants in the intervention group (IG) received aromatherapy massage 3 times a week. There was no intervention in weeks 7 and 8. The control group (CG) received routine care. Neuropathic pain was identified using the Douleur Neuropathique 4 Questions; severity of painful paresthesia was assessed with the numerical rating scale; fatigue severity was identified with the Piper Fatigue Scale. RESULTS At week 6, the rate of neuropathic pain was significantly lower in the IG, when compared with the CG. The severity of painful paresthesia based on numerical rating scale in the IG was significantly lower than that in the CG at weeks 2, 4, and 6. At week 8, fatigue severity in the IG was significantly lower when compared with CG (P < .05). CONCLUSION Aromatherapy massage may be useful in the management of chemotherapy-induced peripheral neuropathic pain and fatigue. IMPLICATIONS FOR PRACTICE This pilot study suggests that aromatherapy massage may be useful to relieve neuropathic pain and fatigue. However, there is a need for further clinical trials to validate the results of this study.
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Choe YH, Kim SH, Oh HS, Seo WS, Lee SH. Chemotherapy-induced Peripheral Neuropathy in Patients with Breast Cancer: Associated Factors and Impact on Health-Related Quality of Life. ASIAN ONCOLOGY NURSING 2020. [DOI: 10.5388/aon.2020.20.2.83] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Yu Hyeon Choe
- Department of Nursing, Inha University, Incheon, Korea
| | - Soo Hyun Kim
- Department of Nursing, Inha University, Incheon, Korea
| | - Hyun Soo Oh
- Department of Nursing, Inha University, Incheon, Korea
| | - Wha Sook Seo
- Department of Nursing, Inha University, Incheon, Korea
| | - Sun Hee Lee
- Department of Nursing, Chodang University, Muan, Korea
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Ax AK, Johansson B, Carlsson M, Nordin K, Börjeson S. Exercise: A positive feature on functioning in daily life during cancer treatment - Experiences from the Phys-Can study. Eur J Oncol Nurs 2019; 44:101713. [PMID: 31877511 DOI: 10.1016/j.ejon.2019.101713] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/05/2019] [Accepted: 12/09/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE Impaired functioning due to cancer treatment is a challenge for daily life. Exercise during treatment can improve functioning. However, research describing experiences of how exercise affects activities of daily life is limited. We aimed to explore how individuals with cancer receiving curative treatment and participating in an exercise intervention experienced their functioning in daily life. METHODS Twenty-one participants were recruited from Phys-Can, an exercise intervention study. Semi-structured interviews were conducted after the intervention had finished, and data was analysed using thematic analysis. RESULTS Two main themes evolved: "Striving to maintain a normal life in a new context" and "Struggling with impairments from side effects of cancer treatment". The supervised group exercise proved popular, and participants reported positive effects on physical and psychological functioning, as well as social and informative support from other participants. Participants struggled with impaired cognitive and physical functioning and exhaustion. They strove to maintain a normal life by adjusting their activities. CONCLUSIONS Perceived physical and psychological benefits from exercise during cancer treatment suggest that exercise should be a part of cancer rehabilitation to facilitate activities and participation in daily life. Striving to maintain a normal life during cancer treatment is vital, and adjustments are needed to maintain activities and participation in daily life. Cancer nurses should motivate patients to engage in physical activity and encourage the introduction of exercise as part of their rehabilitation. They could also support patients in making adjustments to maintain functioning in daily life.
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Affiliation(s)
- Anna-Karin Ax
- Department of Oncology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
| | - Birgitta Johansson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | - Maria Carlsson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | - Karin Nordin
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway.
| | - Sussanne Börjeson
- Department of Oncology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
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Kanzawa-Lee GA, Knoerl R, Donohoe C, Bridges CM, Smith EML. Mechanisms, Predictors, and Challenges in Assessing and Managing Painful Chemotherapy-Induced Peripheral Neuropathy. Semin Oncol Nurs 2019; 35:253-260. [PMID: 31053396 DOI: 10.1016/j.soncn.2019.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To describe the known predictors and pathophysiological mechanisms of chronic painful chemotherapy-induced peripheral neuropathy (CIPN) in cancer survivors and the challenges in assessing and managing it. DATA SOURCES PubMed/Medline, CINAHL, Scopus, and PsycINFO. CONCLUSION The research on chronic painful CIPN is limited. Additional research is needed to identify the predictors and pathophysiological mechanisms of chronic painful CIPN to inform the development of assessment tools and management options for this painful and possibly debilitating condition. IMPLICATIONS FOR NURSING PRACTICE Recognition of the predictors of chronic painful CIPN and proactive CIPN assessment and palliative management are important steps in reducing its impact on physical function and quality of life.
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Affiliation(s)
| | - Robert Knoerl
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA
| | - Clare Donohoe
- School of Nursing, University of Michigan, Ann Arbor, MI
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Mechanisms of Chemotherapy-Induced Peripheral Neuropathy. Int J Mol Sci 2019; 20:ijms20061451. [PMID: 30909387 PMCID: PMC6471666 DOI: 10.3390/ijms20061451] [Citation(s) in RCA: 380] [Impact Index Per Article: 76.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/16/2019] [Accepted: 03/19/2019] [Indexed: 12/18/2022] Open
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects caused by antineoplastic agents, with a prevalence from 19% to over 85%. Clinically, CIPN is a mostly sensory neuropathy that may be accompanied by motor and autonomic changes of varying intensity and duration. Due to its high prevalence among cancer patients, CIPN constitutes a major problem for both cancer patients and survivors as well as for their health care providers, especially because, at the moment, there is no single effective method of preventing CIPN; moreover, the possibilities of treating this syndrome are very limited. There are six main substance groups that cause damage to peripheral sensory, motor and autonomic neurons, which result in the development of CIPN: platinum-based antineoplastic agents, vinca alkaloids, epothilones (ixabepilone), taxanes, proteasome inhibitors (bortezomib) and immunomodulatory drugs (thalidomide). Among them, the most neurotoxic are platinum-based agents, taxanes, ixabepilone and thalidomide; other less neurotoxic but also commonly used drugs are bortezomib and vinca alkaloids. This paper reviews the clinical picture of CIPN and the neurotoxicity mechanisms of the most common antineoplastic agents. A better understanding of the risk factors and underlying mechanisms of CIPN is needed to develop effective preventive and therapeutic strategies.
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Chemokine CCL2 and its receptor CCR2 in the dorsal root ganglion contribute to oxaliplatin-induced mechanical hypersensitivity. Pain 2019; 159:1308-1316. [PMID: 29554018 DOI: 10.1097/j.pain.0000000000001212] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Activation of innate immune mechanisms within the dorsal root ganglion and spinal dorsal horn has been shown to play a key role in the development of neuropathic pain including paclitaxel-related chemotherapy-induced peripheral neuropathy (CIPN). Here, we tested whether similar mechanisms are generalizable to oxaliplatin-induced CIPN. After a single intraperitoneal injection of 3 mg/kg oxaliplatin, mechanical withdrawal threshold and the expression of C-C chemokine ligand 2 (CCL2) and its receptor, CCR2, in the dorsal root ganglion were measured by behavioral testing and immunohistochemical staining, respectively. Mechanical responsiveness increased from the first day after oxaliplatin injection and persisted until day 15, the last day of this experiment. Immunohistochemical showed that the expression of CCL2/CCR2 started to increase by 4 hours after oxaliplatin treatment, was significantly increased at day 4, and then both signals became normalized by day 15. Cotreatment with intrathecal anti-CCL2 antibodies prevented the development of oxaliplatin-induced mechanical hyperresponsiveness, and transiently reversed established hyperalgesia when given 1 week after chemotherapy. This is the first study to demonstrate CCL2/CCR2 signaling in a model of oxaliplatin-related CIPN; and it further shows that blocking of this signal can attenuate the development of oxaliplatin-induced mechanical hyperalgesia. Activation of innate immune mechanisms may therefore be a generalized basis for CIPN irrespective of the specific class of agent.
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Oh PJ, Choi ES, Lee J. The Experience of Chemotherapy-induced Peripheral Neuropathy in People with Cancer. ASIAN ONCOLOGY NURSING 2019. [DOI: 10.5388/aon.2019.19.2.81] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Pok Ja Oh
- Department of Nursing, Sahmyook University, Seoul, Korea
| | | | - Jin Lee
- Department of Nursing, Graduate School, Sahmyook University, Seoul, Korea
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Hsu SY, Huang WS, Lee SH, Chu TP, Lin YC, Lu CH, Beaton RD, Jane SW. Incidence, severity, longitudinal trends and predictors of acute and chronic oxaliplatin-induced peripheral neuropathy in Taiwanese patients with colorectal cancer. Eur J Cancer Care (Engl) 2018; 28:e12976. [PMID: 30536809 DOI: 10.1111/ecc.12976] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 10/01/2018] [Accepted: 10/31/2018] [Indexed: 01/27/2023]
Abstract
The purpose of this study was to evaluate the longitudinal incidence, severity, pattern of changes or predictors of oxaliplatin-induced peripheral neuropathy (OXAIPN) in Taiwanese patients with colorectal cancer. A longitudinal repeated measures study design was employed, and 77 participants were recruited from the colorectal and oncology departments of two teaching medical centres in Taiwan. Physical examinations were performed, and self-reports regarding adverse impacts of OXAIPN and quality of life were obtained at five time points throughout 12 cycles of chemotherapy (C/T). The incidence of OXAIPN increased with C/T cycles (31.1%-81.9%), and the upper limb numbness and cold sensitivity were most significant acute OXAIPN symptoms (29.9%-73.6%). Findings also documented significant increases in overall severity, symptom distress, interference and physical results associated with OXAIPN over the course of C/T. Predictors of OXAIPN severity varied by treatment cycle, including younger patient, higher cumulative dose of oxaliplatin, greater body surface area, receipt of chemotherapy in winter and the occurrence of OXAIPN during prior C/T cycles. The results from this study might help healthcare providers to recognise the symptom characteristics, degree of influences, trends and high-risk group of OXAIPN, facilitating early evaluation and potential interventions to mitigate or prevent negative effects of OXAIPN on patients.
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Affiliation(s)
- Shu-Yi Hsu
- Department of Internal Medicine, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Wen-Shih Huang
- Division of Colon/Rectal, Department of Surgical Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
| | - Shu-Hui Lee
- Department of Nursing, Chang Gung Memorial Hospital, Lin-Ko, Taiwan
| | - Tsui-Ping Chu
- Department of Nursing, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
| | - Yung-Chang Lin
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Ko, Taiwan
| | - Chang-Hsien Lu
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
| | - Randal D Beaton
- Psychosocial & Community Health and Health Services, Schools of Nursing and Public Health, University of Washington, Seattle, Washington
| | - Sui-Whi Jane
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Ko, Taiwan.,Department of Nursing and Graduate Institute of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan
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Reliability and validity of the Chinese version neuropathic pain symptom inventory in patients with colorectal cancer. J Formos Med Assoc 2018; 117:1019-1026. [DOI: 10.1016/j.jfma.2017.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 09/15/2017] [Accepted: 11/21/2017] [Indexed: 01/19/2023] Open
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25
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Brozou V, Vadalouca A, Zis P. Pain in Platin-Induced Neuropathies: A Systematic Review and Meta-Analysis. Pain Ther 2017; 7:105-119. [PMID: 29196945 PMCID: PMC5993684 DOI: 10.1007/s40122-017-0092-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Indexed: 01/01/2023] Open
Abstract
Introduction Platin-induced peripheral neuropathy (PIPN) is a common cause of PN in cancer patients. The aim of this paper is to systematically review the current literature regarding PIPN, with a particular focus on epidemiological and clinical characteristics of painful PIPN, and to discuss relevant management strategies. Methods A systematic computer-based literature search was conducted on the PubMed database. Results This search strategy resulted in the identification of 353 articles. After the eligibility assessment, 282 articles were excluded. An additional 24 papers were identified by scanning the reference lists. In total, 95 papers met the inclusion criteria and were used for this review. The prevalence of neuropathic symptoms due to acute toxicity of oxaliplatin was estimated at 84.6%, whereas PN established after chemotherapy with platins was estimated at 74.9%. Specifically regarding pain, the reported prevalence of pain due to acute toxicity of oxaliplatin was estimated at 55.6%, whereas the reported prevalence of chronic peripheral neuropathic pain in PIPN was estimated at 49.2%. Conclusion Peripheral neuropathy is a common complication in patients receiving platins and can be particularly painful. There is significant heterogeneity among studies regarding the method for diagnosing peripheral neuropathy. Nerve conduction studies are the gold standard and should be performed in patients receiving platins and complaining of neuropathic symptoms post-treatment.
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Affiliation(s)
| | | | - Panagiotis Zis
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
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Lu LC, Huang XY, Chen CC. The lived experiences of patients with post-operative rectal cancer who suffer from altered bowel function: A phenomenological study. Eur J Oncol Nurs 2017; 31:69-76. [PMID: 29173830 DOI: 10.1016/j.ejon.2017.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/28/2017] [Accepted: 10/16/2017] [Indexed: 01/05/2023]
Abstract
PURPOSE Altered bowel function is a common consequence of anal sphincter-saving surgery in rectal cancer patients, and bowel symptoms influence patients' daily life and psychosocial status. Patients have inadequate professional support because care specialists fail do fully appreciate the impact of the patients' symptoms. In-depth exploration of the individual's experience is essential to improve the quality of patient care. The purpose of this study was to explore the lived experiences of post-operative rectal cancer patients with altered bowel function. METHODS This Husserlian descriptive phenomenological study recruited 16 post-operative rectal cancer patients with altered bowel function. Data was collected through purposive sampling and one-on-one in-depth, semi-structured interviews. Narratives were analyzed thematically using Colaizzi's seven-step method. RESULTS Three themes emerged, namely: "living in the restroom", "never backward", and "rebalancing on a new road". "Living in the restroom" described how patients frequent the restroom due to post-operative physical changes. "Never backward" outlined that such changes disturbed their mood, interrupted their daily activities, and affected their family life. "Rebalancing on a new road" described the patients' coping strategies, which included spiritual reconstruction, a new excrement model, an adjusted lifestyle, and peer support. CONCLUSIONS Post-operative rectal cancer patients with altered bowel function frequent the restroom for prolonged periods, which disturbs their psychosocial status. However, they are forced to develop coping methods by themselves. Specialists can offer effective early post-operative interventions by thoroughly understanding each patient's symptomatic experience, symptom-related interferences, and primary concerns.
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Affiliation(s)
- Ling-Chun Lu
- Graduate Institute of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming Te Road, 11219, Beitou, Taipei, Taiwan, ROC; Department of Nursing, Koo Foundation Sun Yat-Sen Cancer Center, 125, Lide Road, 11259, Beitou, Taipei, Taiwan, ROC.
| | - Xuan-Yi Huang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming Te Road, 11219, Beitou, Taipei, Taiwan, ROC.
| | - Chien-Chih Chen
- School of Medicine, National Yang-Ming University, Department of Surgery, Division of Colorectal Surgery, Koo Foundation Sun Yat-Sen Cancer Center, 125, Lide Road, 11259, Beitou, Taipei, Taiwan, ROC.
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Ibudilast reduces oxaliplatin-induced tactile allodynia and cognitive impairments in rats. Behav Brain Res 2017; 334:109-118. [DOI: 10.1016/j.bbr.2017.07.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 07/13/2017] [Accepted: 07/18/2017] [Indexed: 01/05/2023]
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Hsieh YL, Chen HY, Yang CH, Yang CC. Analgesic Effects of Transcutaneous Ultrasound Nerve Stimulation in a Rat Model of Oxaliplatin-Induced Mechanical Hyperalgesia and Cold Allodynia. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:1466-1475. [PMID: 28433438 DOI: 10.1016/j.ultrasmedbio.2017.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 02/22/2017] [Accepted: 03/06/2017] [Indexed: 06/07/2023]
Abstract
This study investigated the effects and underlying mechanisms of therapeutic ultrasound (TUS) in a rat model of oxaliplatin-induced peripheral neuropathy. Animals received a total of eight injections with oxaliplatin (4 mg/kg), administered at 3-d intervals. TUS intervention (1 MHz, 0.5 W/cm2) started on the fifth oxaliplatin administration and continued for 10 consecutive d. Sensory behavioral examinations, protein levels of transient receptor potential channels (TRPM8 and TRPV1) in dorsal root ganglia (DRG) and substance P (SP) in spinal dorsal horn were examined. Results indicated that TUS can reduce mechanical and cold hyper-responsive behaviors caused by repeated administration of oxaliplatin. Oxaliplatin-related increases in protein levels of TRPM8 in DRG and SP in the dorsal horn were also reduced after TUS. Taken together, the results revealed beneficial effects of TUS on oxaliplatin-induced mechanical hyperalgesia and cold allodynia and suggested involvement of TUS biochemicals in suppressing TRPM8 in DRG and SP in spinal cords.
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Affiliation(s)
- Yueh-Ling Hsieh
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan.
| | - Han-Yu Chen
- Department of Physical Therapy, Hung-Kuang University, Taichung, Taiwan
| | - Ching-Hsiang Yang
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
| | - Chen-Chia Yang
- Kao-An Physical Medicine and Rehabilitation Clinic, Taichung, Taiwan
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Neurotoxicity Outcomes in a Population-based Cohort of Elderly Patients Treated With Adjuvant Oxaliplatin for Colorectal Cancer. Clin Colorectal Cancer 2017; 16:397-404.e1. [PMID: 28434884 DOI: 10.1016/j.clcc.2017.03.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 03/16/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND The addition of oxaliplatin to adjuvant treatment regimens for colorectal cancer has been shown to improve overall survival at the expense of increased toxicity. The incidence and severity of toxicity might be greater among older patients who might also derive less benefit from oxaliplatin. We evaluated the association between adjuvant oxaliplatin-based chemotherapy and neurotoxicity outcomes in an elderly cohort of patients. PATIENTS AND METHODS A population-based cohort of patients aged > 65 years with stage II and III colorectal cancer treated with adjuvant therapy in Ontario, Canada was identified using the Ontario Cancer Registry. Cause-specific hazard models were used to estimate the effect of oxaliplatin exposure on the cause-specific hazard ratio (CHR) of peripheral neuropathy after accounting for the competing risk of death. RESULTS We identified 3607 patients aged > 65 years with stage II and III colorectal cancer. Of these patients, 1541 (43%) had been treated with an oxaliplatin-based regimen. Compared with subjects receiving non-oxaliplatin-based regimens, patients aged ≥ 70 years at the time of cancer diagnosis who are subsequently treated with oxaliplatin were more likely to develop peripheral neuropathy (CHR, 2.3; 95% confidence interval [CI], 1.53-3.35; P < .0001). This association was not significant in patients aged 66 to 69 years (CHR, 0.93; 95% CI, 0.50-1.72; P = .812). Formal interaction testing confirmed that the effect of oxaliplatin on neuropathy was more pronounced in patients aged ≥ 70 years compared with patients aged 66 to 69 years (P = .03). CONCLUSION Colorectal cancer patients aged ≥ 70 years at the time of cancer diagnosis who are subsequently treated with oxaliplatin have a significant risk of developing peripheral neuropathy. This should be considered in clinical decision making, especially because of the limited data supporting an oxaliplatin benefit in this age group.
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Cabilan CJ, Hines S. The short-term impact of colorectal cancer treatment on physical activity, functional status and quality of life: a systematic review. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2017; 15:517-566. [PMID: 28178025 DOI: 10.11124/jbisrir-2016003282] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Physical activity, functional status and quality of life (QoL) are important determinants of the quality of life (QoL) after colorectal cancer (CRC) treatment; however, little is known on how the treatment impacts these outcomes. Having this understanding could help clinicians develop and implement strategies that would enhance or maintain the QoL of CRC patients. OBJECTIVES To identify the impact of curative CRC treatment (surgery with or without radiotherapy and/or chemotherapy) on physical activity, functional status and QoL within one year of treatment or diagnosis. INCLUSION CRITERIA TYPES OF PARTICIPANTS Colorectal cancer survivors aged 18 years and over. TYPES OF INTERVENTIONS Curative CRC treatment, which was surgery with or without radiotherapy and/or chemotherapy. TYPES OF STUDIES Pre- and post-observational and experimental studies. OUTCOMES Physical activity, ability to perform activities of daily living (functional status) and QoL. SEARCH STRATEGY CINAHL, Embase, MEDLINE, OpenGrey and ProQuest Dissertations and Theses were used to obtain published and unpublished studies in English. The date range was the start of indexing to February 2015. METHODOLOGICAL QUALITY All studies were assessed independently by two reviewers for relevance, eligibility and methodological quality. DATA EXTRACTION Data from included papers were extracted using a modified data extraction tool. Data that were presented graphically were extracted using online software. DATA SYNTHESIS The differences between postoperative and baseline values were calculated using the Review Manager 5.3.5 (Copenhagen: The Nordic Cochrane Centre, Cochrane) calculator and expressed as mean difference and their corresponding 95% confidence interval. Where possible, study results were pooled in statistical meta-analysis. The physical activity, functional status and some QoL results are presented in a narrative and table form. RESULTS A total of 23 studies were included in this review: two studies (N = 2019 patients) evaluated physical activity, two studies (N = 6908 patients) assessed functional status and 22 studies (N = 2890 patients) measured QoL. Physical activity was observed to decrease at six months after treatment. The functional status of CRC patients decreased, particularly in the elderly (Summary of findings 1 and 2). As for QoL, only the physical and functional aspects were seen to decline up to six months, but scores almost returned to baseline levels at one year after treatment. The QoL studies that used the European Organization for Research and Treatment of Cancer QLQ-C30 tool were pooled in statistical meta-analysis and summarized in Summary of findings 2. The results must be interpreted carefully due to the heterogeneity of studies and scarcity of recent studies. CONCLUSION In spite of the limitations, it is likely that the physical and functional capacity of CRC survivors deteriorates after treatment. IMPLICATIONS FOR PRACTICE The period between diagnosis and treatment provides an opportunity for clinicians to implement interventions (e.g. exercise interventions) that could enhance or restore the physical and functional capacity of CRC survivors. IMPLICATIONS FOR RESEARCH The paucity of studies and heterogeneity need to be addressed. The outcomes for colon and rectal cancer survivors, ostomates and non-ostomates must be analyzed separately.
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Affiliation(s)
- C J Cabilan
- 1Nursing Research Centre, Mater Misericordiae Limited, and The Queensland Centre for Evidence Based Nursing and Midwifery: a Joanna Briggs Institute Centre of Excellence 2School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
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Drott J, Vilhelmsson M, Kjellgren K, Berterö C. Experiences With a Self-Reported Mobile Phone-Based System Among Patients With Colorectal Cancer: A Qualitative Study. JMIR Mhealth Uhealth 2016; 4:e66. [PMID: 27282257 PMCID: PMC4919552 DOI: 10.2196/mhealth.5426] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/17/2016] [Accepted: 04/22/2016] [Indexed: 11/16/2022] Open
Abstract
Background In cancer care, mobile phone-based systems are becoming more widely used in the assessment, monitoring, and management of side effects. Objective To explore the experiences of patients with colorectal cancer on using a mobile phone-based system for reporting neurotoxic side effects. Methods Eleven patients were interviewed (ages 44-68 years). A semistructured interview guide was used to perform telephone interviews. The interviews were transcribed verbatim and analyzed with qualitative content analysis. Results The patients' experiences of using a mobile phone-based system were identified and constructed as: “being involved,” “pacing oneself,” and “managing the questions.” “Being involved” refers to their individual feelings. Patients were participating in their own care by being observant of the side effects they were experiencing. They were aware that the answers they gave were monitored in real time and taken into account by health care professionals when planning further treatment. “Pacing oneself” describes how the patients can have an impact on the time and place they choose to answer the questions. Answering the questionnaire was easy, and despite the substantial number of questions, it was quickly completed. “Managing the questions” pointed out that the patients needed to be observant because of the construction of the questions. They could not routinely answer all the questions. Patients understood that side effects can vary during the cycles of treatment and need to be assessed repeatedly during treatment. Conclusions This mobile phone-based system reinforced the patients’ feeling of involvement in their own care. The patients were comfortable with the technology and appreciated that the system was not time consuming.
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Affiliation(s)
- Jenny Drott
- Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
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Drott J, Starkhammar H, Kjellgren K, Berterö C. The trajectory of neurotoxic side effects’ impact on daily life: a qualitative study. Support Care Cancer 2016; 24:3455-61. [PMID: 26992409 DOI: 10.1007/s00520-016-3179-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 03/11/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Jenny Drott
- Division of Nursing and Department of Medical and Health Sciences, Linköping University, 581 85, Linköping, Sweden.
| | - Hans Starkhammar
- Regional Cancer Centre, South-East Sweden, Linköping University, Linköping, Sweden
| | - Karin Kjellgren
- Division of Nursing and Department of Medical and Health Sciences, Linköping University, 581 85, Linköping, Sweden
| | - Carina Berterö
- Division of Nursing and Department of Medical and Health Sciences, Linköping University, 581 85, Linköping, Sweden
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Wang XS, Shi Q, Dougherty PM, Eng C, Mendoza TR, Williams LA, Fogelman DR, Cleeland CS. Prechemotherapy Touch Sensation Deficits Predict Oxaliplatin-Induced Neuropathy in Patients with Colorectal Cancer. Oncology 2016; 90:127-35. [PMID: 26882477 DOI: 10.1159/000443377] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 12/09/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE We examined the emergence of chemotherapy-induced peripheral neuropathy (CIPN), a dose-limiting toxicity of oxaliplatin, over the course of oxaliplatin-based chemotherapy for colorectal cancer (CRC). Predicting which patients will likely develop CIPN is an ongoing clinical challenge. METHODS Oxaliplatin-naïve patients with CRC underwent quantitative sensory testing (QST) before beginning oxaliplatin-based chemotherapy and then rated CIPN-related symptoms via the MD Anderson Symptom Inventory (MDASI) weekly for 26 weeks. Mixed modeling examined the value of QST for predicting higher CIPN (MDASI numbness/tingling) during treatment. Trajectory analysis identified a patient subgroup with consistently higher CIPN symptoms. RESULTS Numbness/tingling was the most frequent, most severe symptom, with 51% of patients clustering into a high CIPN subgroup. Touch sensation deficits (Bumps Detection test) significantly predicted the development of more severe numbness/tingling [estimate (est) = 0.106, p = 0.0003]. The high CIPN subgroup reported increased pain (est = 0.472, p < 0.0001) and interference with walking (est = 0.840, p < 0.0001). In the high CIPN subgroup, patient-reported numbness/tingling worsened rapidly in weeks 0-5 (est = 0.57, p < 0.0001) and then more gradually in weeks 6-26 (est = 0.07, p < 0.0001). CONCLUSION Prechemotherapy screening with a simple, easily administered objective measure of touch sensation deficits (Bumps Detection test) and monitoring of patient-reported numbness/tingling during the first 2-3 chemotherapy cycles may support improved personalized care of CRC patients with oxaliplatin-induced CIPN.
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Affiliation(s)
- Xin Shelley Wang
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Tex., USA
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Yeo JH, Yoon SY, Kim SJ, Oh SB, Lee JH, Beitz AJ, Roh DH. Clonidine, an alpha-2 adrenoceptor agonist relieves mechanical allodynia in oxaliplatin-induced neuropathic mice; potentiation by spinal p38 MAPK inhibition without motor dysfunction and hypotension. Int J Cancer 2016; 138:2466-76. [PMID: 26704560 DOI: 10.1002/ijc.29980] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 11/26/2015] [Accepted: 12/14/2015] [Indexed: 01/18/2023]
Abstract
Cancer chemotherapy with platinum-based antineoplastic agents including oxaliplatin frequently results in a debilitating and painful peripheral neuropathy. We evaluated the antinociceptive effects of the alpha-2 adrenoceptor agonist, clonidine on oxaliplatin-induced neuropathic pain. Specifically, we determined if (i) the intraperitoneal (i.p.) injection of clonidine reduces mechanical allodynia in mice with an oxaliplatin-induced neuropathy and (ii) concurrent inhibition of p38 mitogen-activated protein kinase (MAPK) activity by the p38 MAPK inhibitor SB203580 enhances clonidine's antiallodynic effect. Clonidine (0.01-0.1 mg kg(-1), i.p.), with or without SB203580(1-10 nmol, intrathecal) was administered two weeks after oxaliplatin injection(10 mg kg(-1), i.p.) to mice. Mechanical withdrawal threshold, motor coordination and blood pressure were measured. Postmortem expression of p38 MAPK and ERK as well as their phosphorylated forms(p-p38 and p-ERK) were quantified 30 min or 4 hr after drug injection in the spinal cord dorsal horn of treated and control mice. Clonidine dose-dependently reduced oxaliplatin-induced mechanical allodynia and spinal p-p38 MAPK expression, but not p-ERK. At 0.1 mg kg(-1), clonidine also impaired motor coordination and decreased blood pressure. A 10 nmol dose of SB203580 alone significantly reduced mechanical allodynia and p-p38 MAPK expression, while a subeffective dose(3 nmol) potentiated the antiallodynic effect of 0.03 mg kg(-1) clonidine and reduced the increased p-p38 MAPK. Coadministration of SB203580 and 0.03 mg kg(-1) clonidine decreased allodynia similar to that of 0.10 mg kg(-1) clonidine, but without significant motor or vascular effects. These findings demonstrate that clonidine treatment reduces oxaliplatin-induced mechanical allodynia. The concurrent administration of SB203580 reduces the dosage requirements for clonidine, thereby alleviating allodynia without producing undesirable motor or cardiovascular effects.
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Affiliation(s)
- Ji-Hee Yeo
- Department of Oral Physiology and Research Center for Tooth and Periodontal Tissue Regeneration, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Seo-Yeon Yoon
- Pain Cognitive Function Research Center, Department of Brain and Cognitive Sciences College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.,Department of Neurobiology and Physiology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Sol-Ji Kim
- Department of Oral Physiology and Research Center for Tooth and Periodontal Tissue Regeneration, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Seog-Bae Oh
- Pain Cognitive Function Research Center, Department of Brain and Cognitive Sciences College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.,Department of Neurobiology and Physiology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jang-Hern Lee
- Department of Veterinary Physiology, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Alvin J Beitz
- Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN
| | - Dae-Hyun Roh
- Department of Oral Physiology and Research Center for Tooth and Periodontal Tissue Regeneration, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
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Ferrier J, Bayet-Robert M, Dalmann R, El Guerrab A, Aissouni Y, Graveron-Demilly D, Chalus M, Pinguet J, Eschalier A, Richard D, Daulhac L, Marchand F, Balayssac D. Cholinergic Neurotransmission in the Posterior Insular Cortex Is Altered in Preclinical Models of Neuropathic Pain: Key Role of Muscarinic M2 Receptors in Donepezil-Induced Antinociception. J Neurosci 2015; 35:16418-30. [PMID: 26674867 PMCID: PMC4679823 DOI: 10.1523/jneurosci.1537-15.2015] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 11/02/2015] [Accepted: 11/07/2015] [Indexed: 01/24/2023] Open
Abstract
Neuropathic pain is one of the most debilitating pain conditions, yet no therapeutic strategy has been really effective for its treatment. Hence, a better understanding of its pathophysiological mechanisms is necessary to identify new pharmacological targets. Here, we report important metabolic variations in brain areas involved in pain processing in a rat model of oxaliplatin-induced neuropathy using HRMAS (1)H-NMR spectroscopy. An increased concentration of choline has been evidenced in the posterior insular cortex (pIC) of neuropathic animal, which was significantly correlated with animals' pain thresholds. The screening of 34 genes mRNA involved in the pIC cholinergic system showed an increased expression of the high-affinity choline transporter and especially the muscarinic M2 receptors, which was confirmed by Western blot analysis in oxaliplatin-treated rats and the spared nerve injury model (SNI). Furthermore, pharmacological activation of M2 receptors in the pIC using oxotremorine completely reversed oxaliplatin-induced mechanical allodynia. Consistently, systemic treatment with donepezil, a centrally active acetylcholinesterase inhibitor, prevented and reversed oxaliplatin-induced cold and mechanical allodynia as well as social interaction impairment. Intracerebral microdialysis revealed a lower level of acetylcholine in the pIC of oxaliplatin-treated rats, which was significantly increased by donepezil. Finally, the analgesic effect of donepezil was markedly reduced by a microinjection of the M2 antagonist, methoctramine, within the pIC, in both oxaliplatin-treated rats and spared nerve injury rats. These findings highlight the crucial role of cortical cholinergic neurotransmission as a critical mechanism of neuropathic pain, and suggest that targeting insular M2 receptors using central cholinomimetics could be used for neuropathic pain treatment. SIGNIFICANCE STATEMENT Our study describes a decrease in cholinergic neurotransmission in the posterior insular cortex in neuropathic pain condition and the involvement of M2 receptors. Targeting these cortical muscarinic M2 receptors using central cholinomimetics could be an effective therapy for neuropathic pain treatment.
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Affiliation(s)
- Jérémy Ferrier
- Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, F-63000 Clermont-Ferrand, France, Inserm, U1107 NEURO-DOL, F-63001 Clermont-Ferrand, France, Institut Analgesia, F-63000 Clermont-Ferrand, France
| | - Mathilde Bayet-Robert
- Université Lyon, CNRS, ENS Lyon, UCB Lyon 1, Ctr RMN Très Hauts Champs, F-69100 Villeurbanne, France
| | - Romain Dalmann
- Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, F-63000 Clermont-Ferrand, France, Inserm, U1107 NEURO-DOL, F-63001 Clermont-Ferrand, France, Institut Analgesia, F-63000 Clermont-Ferrand, France
| | - Abderrahim El Guerrab
- Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, F-63000 Clermont-Ferrand, France, Inserm, U1107 NEURO-DOL, F-63001 Clermont-Ferrand, France, Centre Jean Perrin, ERTICA EA4677 Université d'Auvergne, F-63001, Clermont-Ferrand, France
| | | | - Danielle Graveron-Demilly
- Université Lyon 1, Inserm U1044, CNRS UMR 5220, Laboratory CREATIS, F-69616 Villeurbanne, France, and
| | - Maryse Chalus
- Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, F-63000 Clermont-Ferrand, France, Inserm, U1107 NEURO-DOL, F-63001 Clermont-Ferrand, France, Institut Analgesia, F-63000 Clermont-Ferrand, France
| | - Jérémy Pinguet
- Institut Analgesia, F-63000 Clermont-Ferrand, France, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Alain Eschalier
- Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, F-63000 Clermont-Ferrand, France, Inserm, U1107 NEURO-DOL, F-63001 Clermont-Ferrand, France, Institut Analgesia, F-63000 Clermont-Ferrand, France, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Damien Richard
- Institut Analgesia, F-63000 Clermont-Ferrand, France, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Laurence Daulhac
- Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, F-63000 Clermont-Ferrand, France, Inserm, U1107 NEURO-DOL, F-63001 Clermont-Ferrand, France, Institut Analgesia, F-63000 Clermont-Ferrand, France
| | - Fabien Marchand
- Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, F-63000 Clermont-Ferrand, France, Inserm, U1107 NEURO-DOL, F-63001 Clermont-Ferrand, France, Institut Analgesia, F-63000 Clermont-Ferrand, France,
| | - David Balayssac
- Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, F-63000 Clermont-Ferrand, France, Inserm, U1107 NEURO-DOL, F-63001 Clermont-Ferrand, France, Institut Analgesia, F-63000 Clermont-Ferrand, France, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France
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Kim HS, Oh EG, Lee H, Kim SH, Kim HK. Predictors of symptom experience in Korean patients with cancer undergoing chemotherapy. Eur J Oncol Nurs 2015; 19:644-53. [DOI: 10.1016/j.ejon.2015.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 04/01/2015] [Accepted: 04/10/2015] [Indexed: 12/20/2022]
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Yeo JH, Yoon SY, Kwon SK, Kim SJ, Lee JH, Beitz AJ, Roh DH. Repetitive Acupuncture Point Treatment with Diluted Bee Venom Relieves Mechanical Allodynia and Restores Intraepidermal Nerve Fiber Loss in Oxaliplatin-Induced Neuropathic Mice. THE JOURNAL OF PAIN 2015; 17:298-309. [PMID: 26604098 DOI: 10.1016/j.jpain.2015.10.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 10/21/2015] [Accepted: 10/24/2015] [Indexed: 01/11/2023]
Abstract
UNLABELLED The chemotherapeutic agent, oxaliplatin, produces a robust painful neuropathy that results in the loss of intraepidermal nerve fibers (IENFs). We have previously reported that an acupuncture point (acupoint) injection of diluted bee venom (DBV) produces a temporary antiallodynic effect in oxaliplatin-induced neuropathic mice. Herein we show a significant long-lasting antinociceptive effect of repetitive DBV acupoint treatment on oxaliplatin-induced mechanical allodynia and a significant reduction in the loss of IENFs. DBV (0.1 mg/kg, subcutaneous) was administered once a day for 18 days beginning on day 15 after oxaliplatin injection. Immunohistochemistry for IENF was performed on the glabrous skin of the hind paw footpad using the pan-neuronal marker, protein gene product 9.5. A temporary increase in mechanical threshold was observed 60 minutes after a single DBV injection into the Zusanli acupoint, and this effect was enhanced over time with repetitive DBV treatments. The basal mechanical threshold before daily DBV injection also increased from day 7 after DBV injections, and peaked at day 14 after DBV treatment. Moreover, the oxaliplatin-induced loss of IENFs was significantly reduced in mice treated repetitively with DBV. Repetitive pretreatment with the α-2 adrenoceptor antagonist, yohimbine, (5 mg/kg, subcutaneous) completely prevented the antiallodynic effects and the increase in IENFs observed in mice treated repetitively with DBV. PERSPECTIVE We showed that repetitive acupoint stimulation with DBV gradually and significantly reduced oxaliplatin-induced mechanical allodynia and restored the loss of IENFs in neuropathic mice via an α-2 adrenoceptor mechanism. Collectively, results of this study suggest that repetitive acupoint treatment with DBV can be a potential strategy for the management of chemotherapy-induced neuropathy.
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Affiliation(s)
- Ji-Hee Yeo
- Department of Oral Physiology and Research Center for Tooth and Periodontal Tissue Regeneration, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Seo-Yeon Yoon
- Department of Brain and Cognitive Sciences College of Natural Sciences, Dental Research Institute and Department of Neurobiology and Physiology, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Soon-Keun Kwon
- Department of Oral Physiology and Research Center for Tooth and Periodontal Tissue Regeneration, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Sol-Ji Kim
- Department of Oral Physiology and Research Center for Tooth and Periodontal Tissue Regeneration, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Jang-Hern Lee
- Department of Veterinary Physiology, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Alvin J Beitz
- Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota
| | - Dae-Hyun Roh
- Department of Oral Physiology and Research Center for Tooth and Periodontal Tissue Regeneration, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
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Salehi Z, Roayaei M. Effect of Vitamin E on Oxaliplatin-induced Peripheral Neuropathy Prevention: A Randomized Controlled Trial. Int J Prev Med 2015; 6:104. [PMID: 26682028 PMCID: PMC4671163 DOI: 10.4103/2008-7802.169021] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 07/22/2015] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Peripheral neuropathy is one of the most important limitations of oxaliplatin base regimen, which is the standard for the treatment of colorectal cancer. Evidence has shown that Vitamin E may be protective in chemotherapy-induced peripheral neuropathy. The aim of this study is to evaluate the effect of Vitamin E administration on prevention of oxaliplatin-induced peripheral neuropathy in patients with colorectal cancer. METHODS This was a prospective randomized, controlled clinical trial. Patients with colorectal cancer and scheduled to receive oxaliplatin-based regimens were enrolled in this study. Enrolled patients were randomized into two groups. The first group received Vitamin E at a dose of 400 mg daily and the second group observed, until after the sixth course of the oxaliplatin regimen. For oxaliplatin-induced peripheral neuropathy assessment, we used the symptom experience diary questionnaire that completed at baseline and after the sixth course of chemotherapy. Only patients with a score of zero at baseline were eligible for this study. RESULTS Thirty-two patients were randomized to the Vitamin E group and 33 to the control group. There was no difference in the mean peripheral neuropathy score changes (after - before) between two groups, after sixth course of the oxaliplatin base regimen (mean difference [after - before] of Vitamin E group = 6.37 ± 2.85, control group = 6.57 ± 2.94; P = 0.78). Peripheral neuropathy scores were significantly increased after intervention compared with a base line in each group (P < 0.001). CONCLUSIONS The results from this current trial demonstrate a lack of benefit for Vitamin E in preventing oxaliplatin-induced peripheral neuropathy.
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Affiliation(s)
- Zeinab Salehi
- Department of Radiotherapy and Oncology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Roayaei
- Department of Radiotherapy and Oncology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Pachman DR, Qin R, Seisler DK, Smith EML, Beutler AS, Ta LE, Lafky JM, Wagner-Johnston ND, Ruddy KJ, Dakhil S, Staff NP, Grothey A, Loprinzi CL. Clinical Course of Oxaliplatin-Induced Neuropathy: Results From the Randomized Phase III Trial N08CB (Alliance). J Clin Oncol 2015; 33:3416-22. [PMID: 26282635 DOI: 10.1200/jco.2014.58.8533] [Citation(s) in RCA: 191] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Given that the clinical course of oxaliplatin-induced neuropathy is not well defined, the current study was performed to better understand clinical parameters associated with its presentation. METHODS Acute and chronic neuropathy was evaluated in patients receiving adjuvant FOLFOX (fluorouracil, leucovorin, and oxaliplatin) on study N08CB (North Central Cancer Treatment Group, Alliance). Acute neuropathy was assessed by having patients complete daily questionnaires for 6 days with each cycle of FOLFOX. Before each dose of FOLFOX and as long as 18 months after chemotherapy cessation, chronic neurotoxicity was assessed with use of the 20-item, European Organisation for Research and Treatment of Cancer quality-of-life questionnaire for patients with chemotherapy-induced peripheral neuropathy. RESULTS Three hundred eight (89%) of the 346 patients had at least one symptom of acute neuropathy with the first cycle of FOLFOX; these symptoms included sensitivity to touching cold items (71%), sensitivity to swallowing cold items (71%), throat discomfort (63%), or muscle cramps (42%). Acute symptoms peaked at day 3 and improved, although they did not always resolve completely between treatments. These symptoms were about twice as severe in cycles 2 through 12 as they were in cycle 1. For chronic neurotoxicity, tingling was the most severe symptom, followed by numbness and then pain. During chemotherapy, symptoms in the hands were more prominent than they were in the feet; by 18 months, symptoms were more severe in the feet than they were in the hands. Patients with more severe acute neuropathy during the first cycle of therapy experienced more chronic sensory neurotoxicity (P < .0001). CONCLUSION Acute oxaliplatin-induced neuropathy symptoms do not always completely resolve between treatment cycles and are only half as severe on the first cycle as compared with subsequent cycles. There is a correlation between the severities of acute and chronic neuropathies.
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Affiliation(s)
- Deirdre R Pachman
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS.
| | - Rui Qin
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS
| | - Drew K Seisler
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS
| | - Ellen M L Smith
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS
| | - Andreas S Beutler
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS
| | - Lauren E Ta
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS
| | - Jacqueline M Lafky
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS
| | - Nina D Wagner-Johnston
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS
| | - Kathryn J Ruddy
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS
| | - Shaker Dakhil
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS
| | - Nathan P Staff
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS
| | - Axel Grothey
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS
| | - Charles L Loprinzi
- Deirdre R. Pachman, Rui Qin, Drew K. Seisler, Andreas S. Beutler, Lauren E. Ta, Jacqueline M. Lafky, Kathryn J. Ruddy, Nathan P. Staff, Axel Grothey, and Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Ellen M.L. Smith, University of Michigan, Ann Arbor, MI; Nina D. Wagner-Johnston, Washington University School of Medicine, Saint Louis, MO; and Shaker Dakhil, Cancer Center of Kansas, Wichita, KS
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Up-regulation of CX3CL1 via Nuclear Factor-κB-dependent Histone Acetylation Is Involved in Paclitaxel-induced Peripheral Neuropathy. Anesthesiology 2015; 122:1142-51. [PMID: 25494456 DOI: 10.1097/aln.0000000000000560] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Up-regulation of CX3CL1 has been revealed to be involved in the neuropathic pain induced by nerve injury. However, whether CX3CL1 participates in the paclitaxel-induced painful peripheral neuropathy remains unknown. The aim of the current study was to elucidate the involvement of transcriptional factors nuclear factor-κB (NF-κB) and its causal interaction with CX3CL1 signaling in the paclitaxel-induced painful peripheral neuropathy. METHODS Painful peripheral neuropathy induced by paclitaxel treatment was established in adult male Sprague-Dawley rats. The von Frey test were performed to evaluate neuropathic pain behavior, and real-time quantitative reverse transcription polymerase chain reaction, chromatin immunoprecipitation, Western blot, immunohistochemistry, and small interfering RNA were performed to understand the molecular mechanisms. RESULTS The application of paclitaxel induced an up-regulation of CX3CL1 expression in the spinal neurons, which is reduced significantly by NF-κB inhibitor ammonium pyrrolidinedithiocarbamate or p65 small interfering RNA. Blockade of either CX3CL1 (n = 12 each) or NF-κB (n = 12 each) signaling pathway attenuated mechanical allodynia induced by paclitaxel. Chromatin immunoprecipitation further found that paclitaxel induced an increased recruitment of nuclear factor-κB (NF-κB)p65 to the Cx3cl1 promoter region. Furthermore, an increased acetylation level of H4, but not H3, in Cx3cl1 promoter region in spinal neurons was detected after paclitaxel treatment, which was reversed by inhibition of NF-κB with ammonium pyrrolidinedithiocarbamate or p65 small interfering RNA. CONCLUSIONS These findings suggest that up-regulation of CX3CL1 via NF-κB-dependent H4 acetylation might be critical for paclitaxel-induced mechanical allodynia.
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Gustafsson E, Litström E, Berterö C, Drott J. Reliability testing of oxaliplatin-associated neurotoxicity questionnaire (OANQ), a pilot study. Support Care Cancer 2015; 24:747-754. [PMID: 26137985 DOI: 10.1007/s00520-015-2838-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 06/22/2015] [Indexed: 11/30/2022]
Affiliation(s)
- E Gustafsson
- Department of Surgery and Department of Medical and Health Sciences, Linköping University, 581 85, Linköping, Sweden
| | - E Litström
- Department of Surgery and Department of Medical and Health Sciences, Linköping University, 581 85, Linköping, Sweden
| | - C Berterö
- Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, 581 85, Linköping, Sweden
| | - J Drott
- Department of Surgery and Department of Medical and Health Sciences, Linköping University, 581 85, Linköping, Sweden.
- Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, 581 85, Linköping, Sweden.
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Lolignier S, Bonnet C, Gaudioso C, Noël J, Ruel J, Amsalem M, Ferrier J, Rodat-Despoix L, Bouvier V, Aissouni Y, Prival L, Chapuy E, Padilla F, Eschalier A, Delmas P, Busserolles J. The Nav1.9 channel is a key determinant of cold pain sensation and cold allodynia. Cell Rep 2015; 11:1067-78. [PMID: 25959819 DOI: 10.1016/j.celrep.2015.04.027] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 01/16/2015] [Accepted: 04/13/2015] [Indexed: 12/31/2022] Open
Abstract
Cold-triggered pain is essential to avoid prolonged exposure to harmfully low temperatures. However, the molecular basis of noxious cold sensing in mammals is still not completely understood. Here, we show that the voltage-gated Nav1.9 sodium channel is important for the perception of pain in response to noxious cold. Nav1.9 activity is upregulated in a subpopulation of damage-sensing sensory neurons responding to cooling, which allows the channel to amplify subthreshold depolarizations generated by the activation of cold transducers. Consequently, cold-triggered firing is impaired in Nav1.9(-/-) neurons, and Nav1.9 null mice and knockdown rats show increased cold pain thresholds. Disrupting Nav1.9 expression in rodents also alleviates cold pain hypersensitivity induced by the antineoplastic agent oxaliplatin. We conclude that Nav1.9 acts as a subthreshold amplifier in cold-sensitive nociceptive neurons and is required for the perception of cold pain under normal and pathological conditions.
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Affiliation(s)
- Stéphane Lolignier
- Pharmacologie Fondamentale et Clinique de la Douleur, Clermont Université, Université d'Auvergne, 63000 Clermont-Ferrand, France; Inserm, U 1107, Neuro-Dol, 63000 Clermont-Ferrand, France
| | - Caroline Bonnet
- Aix-Marseille-Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille, UMR 7286, CS80011, Bd Pierre Dramard, 13344 Marseille Cedex 15, France
| | - Christelle Gaudioso
- Aix-Marseille-Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille, UMR 7286, CS80011, Bd Pierre Dramard, 13344 Marseille Cedex 15, France
| | - Jacques Noël
- Institut de Pharmacologie Moléculaire et Cellulaire, LabEx ICST, UMR 7275 CNRS, Université de Nice Sophia Antipolis, 06560 Valbonne, France
| | - Jérôme Ruel
- Aix-Marseille-Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille, UMR 7286, CS80011, Bd Pierre Dramard, 13344 Marseille Cedex 15, France
| | - Muriel Amsalem
- Aix-Marseille-Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille, UMR 7286, CS80011, Bd Pierre Dramard, 13344 Marseille Cedex 15, France
| | - Jérémy Ferrier
- Pharmacologie Fondamentale et Clinique de la Douleur, Clermont Université, Université d'Auvergne, 63000 Clermont-Ferrand, France; Inserm, U 1107, Neuro-Dol, 63000 Clermont-Ferrand, France
| | - Lise Rodat-Despoix
- Aix-Marseille-Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille, UMR 7286, CS80011, Bd Pierre Dramard, 13344 Marseille Cedex 15, France
| | - Valentine Bouvier
- Aix-Marseille-Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille, UMR 7286, CS80011, Bd Pierre Dramard, 13344 Marseille Cedex 15, France
| | - Youssef Aissouni
- Pharmacologie Fondamentale et Clinique de la Douleur, Clermont Université, Université d'Auvergne, 63000 Clermont-Ferrand, France; Inserm, U 1107, Neuro-Dol, 63000 Clermont-Ferrand, France
| | - Laetitia Prival
- Pharmacologie Fondamentale et Clinique de la Douleur, Clermont Université, Université d'Auvergne, 63000 Clermont-Ferrand, France; Inserm, U 1107, Neuro-Dol, 63000 Clermont-Ferrand, France
| | - Eric Chapuy
- Pharmacologie Fondamentale et Clinique de la Douleur, Clermont Université, Université d'Auvergne, 63000 Clermont-Ferrand, France; Inserm, U 1107, Neuro-Dol, 63000 Clermont-Ferrand, France
| | - Françoise Padilla
- Aix-Marseille-Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille, UMR 7286, CS80011, Bd Pierre Dramard, 13344 Marseille Cedex 15, France
| | - Alain Eschalier
- Pharmacologie Fondamentale et Clinique de la Douleur, Clermont Université, Université d'Auvergne, 63000 Clermont-Ferrand, France; Inserm, U 1107, Neuro-Dol, 63000 Clermont-Ferrand, France; Service de Pharmacologie, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - Patrick Delmas
- Aix-Marseille-Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille, UMR 7286, CS80011, Bd Pierre Dramard, 13344 Marseille Cedex 15, France.
| | - Jérôme Busserolles
- Pharmacologie Fondamentale et Clinique de la Douleur, Clermont Université, Université d'Auvergne, 63000 Clermont-Ferrand, France; Inserm, U 1107, Neuro-Dol, 63000 Clermont-Ferrand, France.
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Altaf R, Lund Brixen A, Kristensen B, Nielsen SE. Incidence of cold-induced peripheral neuropathy and dose modification of adjuvant oxaliplatin-based chemotherapy for patients with colorectal cancer. Oncology 2014; 87:167-72. [PMID: 25012613 DOI: 10.1159/000362668] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 04/01/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND The CAPOX regimen is used for adjuvant treatment of colorectal cancer. A well-known side effect of oxaliplatin, which often leads to dose modification (DM), is acute neuropathy (AN). AN is provoked by cold, and it could therefore be expected that the degree of AN and thereby DM is more pronounced in the winter period compared to the summer period. METHOD Patients with colorectal cancer who received adjuvant CAPOX from January 2005 to August 2011 were reviewed. Out of 108 patients who received adjuvant CAPOX, the oxaliplatin dose was reduced in 92 (85%) patients due to AN. Seventeen out of 31 (55%) patients already had a DM of oxaliplatin in the second cycle during the winter period (December to February; mean temperature 0.1-1.8°C), while in the summer period (June to August; mean temperature 15.1-16.3°C), only 4 (13%) patients needed DM (OR = 2.5, p = 0.022). CONCLUSION In this study, we found that the risk of DM and discontinuation of oxaliplatin is highest in the winter period compared to the other seasons. This study draws attention to the importance of training in the proper handling of the acute neurotoxicity of oxaliplatin.
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Affiliation(s)
- Rahim Altaf
- Department of Oncology, Hilleroed Hospital, Hilleroed, Denmark
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Ferrier J, Pereira V, Busserolles J, Authier N, Balayssac D. Emerging trends in understanding chemotherapy-induced peripheral neuropathy. Curr Pain Headache Rep 2014; 17:364. [PMID: 23996720 DOI: 10.1007/s11916-013-0364-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a major concern in oncology practice given the increasing number of cancer survivors and the lack of effective treatment. The incidence of peripheral neuropathy depends upon the anticancer drug used, but is commonly under-reported in clinical trials. Several animal models have been developed in an attempt to better characterize the pathophysiological mechanisms underlying these CIPN and to find more specific treatments. Over the past two decades, three main trends have emerged from preclinical research on CIPN. There is a compelling body of evidence that neurotoxic anticancer drugs affect the peripheral sensory nerve by directly targeting the mitochondria and producing oxidative stress, by functionally impairing the ion channels and/or by triggering immunological mechanisms through the activation of satellite glial cells. These various neurotoxic events may account for the lack of effective treatment, as neuroprotection may probably only be achieved using a polytherapy that targets all of these mechanisms. The aim of this review is to describe the clinical features of CIPN and to summarize the recent trends in understanding its pathophysiology.
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Affiliation(s)
- Jérémy Ferrier
- Clermont Université, Université d'Auvergne, Pharmacologie fondamentale et clinique de la douleur, Clermont-Ferrand, France
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Relationship between Quality of Life and Nurse-led Bedside Symptom Evaluations in Patients with Chemotherapy-induced Peripheral Neuropathy. Asian Nurs Res (Korean Soc Nurs Sci) 2014; 8:36-41. [DOI: 10.1016/j.anr.2013.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 09/23/2013] [Accepted: 10/28/2013] [Indexed: 11/18/2022] Open
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Kim HY, Kang JH, Youn HJ, So HS, Song CE, Chae SY, Jung SH, Kim SR, Kim JY. Reliability and Validity of the Korean Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire to Assess Chemotherapy-induced Peripheral Neuropathy. J Korean Acad Nurs 2014; 44:735-42. [DOI: 10.4040/jkan.2014.44.6.735] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Hye Young Kim
- College of Nursing, Chonbuk National University, Jeonju, Korea
| | - Jeong Hee Kang
- College of Nursing, Chonbuk National University, Jeonju, Korea
| | - Hyun Jo Youn
- Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea
| | - Hyang Sook So
- College of Nursing, Chonnam National University, Gwangju, Korea
| | - Chi Eun Song
- Department of Hematology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Seo Young Chae
- Department of Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Sung Hoo Jung
- Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea
| | - Sung Reul Kim
- College of Nursing, Chonbuk National University, Jeonju, Korea
| | - Ji Young Kim
- College of Nursing, Chonbuk National University, Jeonju, Korea
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Shun SC, Yeh KH, Liang JT, Huang J, Chen SC, Lin BR, Lee PH, Lai YH. Unmet Supportive Care Needs of Patients With Colorectal Cancer: Significant Differences by Type D Personality. Oncol Nurs Forum 2013; 41:E3-11. [DOI: 10.1188/14.onf.e3-e11] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Guo Y, Jones D, Palmer JL, Forman A, Dakhil SR, Velasco MR, Weiss M, Gilman P, Mills GM, Noga SJ, Eng C, Overman MJ, Fisch MJ. Oral alpha-lipoic acid to prevent chemotherapy-induced peripheral neuropathy: a randomized, double-blind, placebo-controlled trial. Support Care Cancer 2013; 22:1223-31. [PMID: 24362907 DOI: 10.1007/s00520-013-2075-1] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 11/25/2013] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Chemotherapy-induced peripheral neuropathy is frequently a dose-limiting factor in cancer treatment and may cause pain and irreversible function loss in cancer survivors. We tested whether alpha-lipoic acid (ALA) could decrease the severity of peripheral neuropathy symptoms in patients undergoing platinum-based chemotherapy. METHODS Cancer patients 18 years or older were randomly selected to receive either 600 mg ALA or a placebo three times a day orally for 24 weeks while receiving chemotherapy regimens including cisplatin or oxaliplatin. Neuropathy was measured by the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) scale and the NCI Common Toxicity Criteria for Adverse Events neurotoxicity grades. Results from timed functional tests and the Brief Pain Inventory (BPI) were secondary endpoints. RESULTS Seventy of 243 (29 %) patients completed the study (24 weeks). Both the ALA and the placebo arms had a comparable drop-out rate. No statistically significant differences were found between the ALA and the placebo groups for FACT/GOG-Ntx scores, BPI scores, and patients' functional outcomes. CONCLUSION This strategy of oral ALA administration was ineffective at preventing neurotoxicity caused by oxaliplatin or cisplatin. High attrition rates due to poor patient compliance and manner of dosage administration in this trial demonstrated a lack of feasibility for this intervention. Future studies to explore ALA as a neuroprotective agent should take heed of the barriers confronted in this study.
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Affiliation(s)
- Ying Guo
- The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1414, Houston, TX, 77030, USA,
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Jeong JH, Nho JH, Kim GS, Lee YE, Yu SY, Lee HJ, Sim YM, Lee YS. Characteristics and Quality of Life in Gynecologic Cancer Patients with Chemotherapy-induced Peripheral Neuropathy. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2013; 19:201-210. [PMID: 37684765 DOI: 10.4069/kjwhn.2013.19.4.201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this study was to identify chemotherapy induced peripheral neuropathy, quality of life of patients with gynecologic cancer. METHODS This was a cross-sectional survey design. We collected 130 patients with gynecologic cancer. They complete a self reported questionnaire including items related neuropathy and quality of life (FACT-GOG/Ntx subscale, FACT-G scale). RESULTS The neuropathy score was 14.3+/-7.9. The quality of life score was 64.8+/-16.4. The neuropathy induced significant difference according to diabetic status, difficulties in performing household chores and willing to discontinuity of chemotherapy. And duration of cancer diagnosis, neuropathy, number of total chemo agent associated with quality of life. There was a negative correlation between number of total chemo agent and quality of life. Neuropathy independently affected quality of life. CONCLUSION Chemotherapy induced peripheral neuropathy of patients with gynecologic cancer adversely affected women's quality of life and activities of daily living. To improve patient's quality of life, it is important that accurate assess and appropriately manage neuropathy in patients with gynecologic cancer.
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Yoon SY, Robinson CR, Zhang H, Dougherty PM. Spinal astrocyte gap junctions contribute to oxaliplatin-induced mechanical hypersensitivity. THE JOURNAL OF PAIN 2013; 14:205-14. [PMID: 23374942 DOI: 10.1016/j.jpain.2012.11.002] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 10/29/2012] [Accepted: 11/07/2012] [Indexed: 01/07/2023]
Abstract
UNLABELLED Spinal glial cells contribute to the development of many types of inflammatory and neuropathic pain. Here the contribution of spinal astrocytes and astrocyte gap junctions to oxaliplatin-induced mechanical hypersensitivity was explored. The expression of glial fibrillary acidic protein (GFAP) in spinal dorsal horn was significantly increased at day 7 but recovered at day 14 after oxaliplatin treatment, suggesting a transient activation of spinal astrocytes by chemotherapy. Astrocyte-specific gap junction protein connexin 43 (Cx43) was significantly increased in dorsal horn at both day 7 and day 14 following chemotherapy, but neuronal (connexin 36 [Cx36]) and oligodendrocyte (connexin 32 [Cx32]) gap junction proteins did not show any change. Blockade of astrocyte gap junction with carbenoxolone (CBX) prevented oxaliplatin-induced mechanical hypersensitivity in a dose-dependent manner and the increase of spinal GFAP expression, but had no effect once the mechanical hypersensitivity induced by oxaliplatin had fully developed. These results suggest that oxaliplatin chemotherapy induces the activation of spinal astrocytes and this is accompanied by increased expression of astrocyte-astrocyte gap junction connections via Cx43. These alterations in spinal astrocytes appear to contribute to the induction but not the maintenance of oxaliplatin-induced mechanical hypersensitivity. Combined, these results suggest that targeting spinal astrocyte/astrocyte-specific gap junction could be a new therapeutic strategy to prevent oxaliplatin-induced neuropathy. PERSPECTIVE Spinal astrocytes but not microglia were recently shown to be recruited in paclitaxel-related chemoneuropathy. Here, spinal astrocyte gap junctions are shown to play an important role in the induction of oxaliplatin neuropathy.
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Affiliation(s)
- Seo-Yeon Yoon
- Laboratory of Molecular Signal Transduction, Center for Neural Science, Korea Institute of Science and Technology, Seoul, South Korea
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