scholarly journals Acupuncture for the Treatment of Taxane-Induced Peripheral Neuropathy in Breast Cancer Patients: A Pilot Trial

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Young Ju Jeong ◽  
Min Ah Kwak ◽  
Jung Chul Seo ◽  
Seong Hoon Park ◽  
Jin Gu Bong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Cancer Patients ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Breast Cancer Patients ◽  
Sf 36 ◽  
Self Administered Questionnaire

Objectives. Some chemotherapy drugs can damage the nerves and cause peripheral neuropathy which is accompanied by severe neuropathic pain or gait impairment. The purpose of this study was to assess the feasibility and the safety of acupuncture for the treatment of peripheral neuropathy following chemotherapy in Korean breast cancer patients. Design. This study was a prospective single-arm observational study using before and after measurements in breast cancer patients presenting with taxane-induced peripheral neuropathy. Settings/Location. This study was performed at East-West Medical Center at Daegu Catholic University Hospital, Daegu, South Korea. Interventions. Acupuncture was administered 3 times a week for 4 consecutive weeks, for 25 ± 5 minutes at each session. Outcome Measures. The primary outcome measure was severity of CIPN using the Neuropathic Pain Symptom Inventory (NPSI) assessed by a self-administered questionnaire and Nerve Conduction Study (NCS) of extremities. The secondary outcome measure was quality of life (QoL) assessed by a self-administered questionnaire using the 36-Item Short From Health Survey (SF-36). Results. Acupuncture significantly reduced the severity of CIPN assessed by NPSI score. Four weeks after the last treatment, the symptoms were not aggravated. According to NCS, 42.9% of participants showed improvement of sensory neuropathy. At the end of the treatment, SF-36 scores were significantly increased for variables including physical functioning, role limitations due to physical health problems, social functioning, and general health perceptions compared to those of baseline measurement. Conclusions. Acupuncture improved symptoms of CIPN and QoL in Korean women suffering from peripheral neuropathy after chemotherapy using taxane for breast cancer. The effects of acupuncture lasted for at least 1 month after the treatment.

Chemotherapy-induced peripheral neuropathy as a predictor of neuropathic pain in breast cancer patients previously treated with paclitaxel

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20505-e20505
Author(s):  
C. C. Reyes-Gibby ◽  
P. Morrow
Keyword(s):  
Breast Cancer ◽  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Cancer Patients ◽  
Significant Proportion ◽  
Sensory Neuropathy ◽  
Breast Cancer Patients ◽  
Comorbid Conditions ◽  
Duration Of Treatment

e20505 Background: Neuropathic pain (NP) remains difficult to control for a significant proportion of patients with cancer. Chemotherapy induced peripheral neuropathy (CIPN) is postulated as an initial stage to the development of NP. Among breast cancer patients, taxanes, platinum agents, and vinca alkaloids are most likely to cause NP. The purpose of this study was to assess the extent to which those who experienced CIPN (NCI toxicity criteria ≥ grade 2 sensory neuropathy) during paclitaxel chemotherapy were at risk of developing chronic NP, controlling for disease- and treatment-related variables (e.g., stage of disease, location of tumor chemotherapy and other cancer therapies, dose of chemotherapy and duration of treatment), clinical health status (e.g., comorbid conditions), and sociodemographic characteristics (e.g., age, race). Methods: We conducted a follow-up survey of breast cancer patients who previously participated in clinical trials for paclitaxel. Patients were asked if they have ever been diagnosed by the physician or healthcare provider for NP during the survey. Clinical trial data (NCI Toxicity, cummulative dose) were abstracted from a clinical database. Results: Of the 430 potential respondents, 240 responded to the survey. Mean follow-up time was 9.5 years (SD=2.1). Sixty three percent of the respondents had grade 2 or greater sensory neuropathy during their previous treatment with paclitaxel. Follow-up data showed that 18% (43/240) were subsequently diagnosed by their physician to have NP. Logistic regression analysis showed that those with CIPN during the trial were 3 times more likely to having been diagnosed with NP (OR=3; 95%CI=1.2; 7.2; p<0.001), which persisted in the multivariable model. Other variables found to be associated with NP included cummulative dose of paclitaxel, and comorbid conditions such as diabetes and osteoarthritis. Patients with NP reported twice as many visits to their health care provider (p=0.028); had taken more prescription (50% versus 19%; p=0.0001) for pain relative to those without NP. Conclusions: We provide empirical evidence on the importance CIPN as a risk factor for NP in breast cancer patients.Prospective studies with larger cohorts are needed to validate our findings. No significant financial relationships to disclose.

scholarly journals Comparison of the clinical effectiveness of treatments for aromatase inhibitor-induced arthralgia in breast cancer patients: a protocol for a systematic review and network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e033461
Author(s):  
Kyeore Bae ◽  
Si Yeon Song
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Pain Intensity ◽  
Aromatase Inhibitor ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Indirect Evidence ◽  
Secondary Outcome ◽  
Breast Cancer Patients ◽  
Patient Reported

IntroductionAromatase inhibitor-induced arthralgia (AIA) is a major adverse event of aromatase inhibitors (AIs) and leads to premature discontinuation of AI therapy in breast cancer patients. The objective of this protocol for a systematic review and network meta-analysis (NMA) is to provide the methodology to compare the change in pain intensity between different AIA treatments and demonstrate the rank probabilities for different treatments by combining all available direct and indirect evidence.Methods and analysisPubMed, the Cochrane Controlled Register of Trials (CENTRAL), EMBASE, Web of Science and ClinicalTrials.gov will be searched to identify publications in English from inception to November 2019. We will include randomised controlled trials (RCTs) assessing the effects of different treatments for AIA in postmenopausal women with stage 0–III hormone receptor-positive breast cancer. The primary endpoints will be the change in patient-reported pain intensity from baseline to post-treatment. The number of adverse events will be presented as a secondary outcome.Both pairwise meta-analysis and NMA with the Frequentist approach will be conducted. We will demonstrate summary estimates with forest plots in meta-analysis and direct and mixed evidence with a ranking of the treatments as the P-score in NMA. The revised Cochrane risk-of-bias tool for randomised trials will be used to assess the methodological quality within individual RCTs. The quality of evidence will be assessed.Ethics and disseminationAs this review does not involve individual patients, ethical approval is not required. The results of this systematic review and NMA will be published in a peer-reviewed journal. This review will provide valuable information on AIA therapeutic options for clinicians, health practitioners and breast cancer survivors.PROSPERO registration numberCRD42019136967.

Taxane-induced peripheral neuropathy and quality of life in breast cancer patients

2020 ◽  
Vol 26 (6) ◽  
pp. 1421-1428
Author(s):  
Ebrahim Salehifar ◽  
Ghasem Janbabaei ◽  
Abbas Alipour ◽  
Nasim Tabrizi ◽  
Razieh Avan
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Health Status ◽  
Peripheral Neuropathy ◽  
Global Health ◽  
Cancer Patients ◽  
Physical Functioning ◽  
Role Functioning ◽  
Breast Cancer Patients

Purpose Taxane-induced peripheral neuropathy (TIPN) is a common and bothersome toxicity. This study aimed to determine the incidence and severity of TIPN in patients with breast cancer and to investigate the relationship between TIPN and quality of life. Methods A total of 82 breast cancer patients with TIPN symptoms were included in this study. The criteria of National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE v4.03) and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30, version 3.0) were used to evaluate grading of sensory neuropathy and quality of life, respectively. Analysis of the data was done by IBM SPSS statistics version 23. Results A total of 346 patients received taxane-based chemotherapy and 82 patients (23.7%) experience TIPN. The mean (SD) global health status/quality of life, physical functioning, role functioning, and pain subscales were 60.63 (5.26), 80.64 (9.05), 81.77 (10.41), and 43.88 (11.27), respectively. There were significant negative correlations between global health status/quality of life, physical functioning, and role functioning subscales with the grade of neuropathy (r = −0.33, −0.80, and −0.61, respectively) and positive correlation between pain subscale and the grade of neuropathy (r = 0.70). Conclusion This study shows a clear association between TIPN and worsened quality of life. These findings emphasize on detecting and management of TIPN in an effort to improve the quality of life of breast cancer patients.

Biopsychosocial problems identified by women with breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19514-19514
Author(s):  
M. Loscalzo ◽  
K. Clark ◽  
J. Mortimer
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Psychosocial Problems ◽  
Complete Information ◽  
Cancer Center ◽  
Breast Cancer Patients ◽  
Common Problems ◽  
Clinically Significant ◽  
Self Administered Questionnaire ◽  
Breast Malignancies

19514 Background: It is frequently assumed that women with breast cancer have higher levels of distress and psychosocial problems than women with other malignancies. We compared the biopsychosocial needs of breast cancer patients with women with non-breast malignancies. Methods: A biopsychosocial screening tool was developed from clinical practice, focus groups, and the administration of questionnaires to over 3,000 patients. The refined 36-item self-administered questionnaire was completed by all new patients evaluated in the Moores Cancer Center. The severity of each problem was scored from 1 (not a problem) to 5 (the worst problem I could have). Problems scored as 3 or above were identified to be clinically significant. The screening results from women with breast cancer were compared with those of women with non-breast malignancies. Results: Between December 2005 and December 2006, 2063 patients completed screening questionnaires. Complete information, including staging, is available on 299 women, 155 of whom were diagnosed with breast cancer and 144 with non-breast malignancies. The two groups were comparable with respect to age, ethnicity, and the number of significant problems reported. The 5 most common problems identified to be significant by breast cancer patients included: fatigue, sleeping, being dependent on others, feeling depressed, and pain. The non-breast cancer women identified a greater number of significant problems overall with the 5 most significant being: fatigue, sleep, controlling my fear and worry about the future, being dependent on others, and pain. Getting medications and recent weight loss were more commonly identified in the non-breast cancer patients (p<0.05). Conclusions: Our data suggest that breast cancer patients identify similar biopsychosocial needs as women with other primary malignancies. No significant financial relationships to disclose.

Does progesterone protect from chemotherapy-induced peripheral neuropathy? A retrospective audit of breast cancer patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11552-e11552
Author(s):  
Aruna Laxman Prabhu ◽  
Akshita Singh ◽  
Rucha Vishal Kaushik ◽  
Nita S. Nair ◽  
Rohini W Hawaldar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Peripheral Neuropathy ◽  
Cancer Patients ◽  
Neuroprotective Effect ◽  
Menopausal Status ◽  
Continuous Variable ◽  
Experimental Models ◽  
Multivariate Logistic Regression Model ◽  
Breast Cancer Patients ◽  
Retrospective Audit

e11552 Background: Paclitaxel is an integral component of chemotherapy for breast cancer but its benefit comes at the risk of peripheral neuropathy. There are experimental models of peripheral nerve injury in which progesterone is protective, possibly through remyelination and other mechanisms. Methods: We evaluated the effect of menopausal status, as a surrogate for circulating progesterone levels, on the risk of developing paclitaxel induced peripheral neuropathy, in a retrospective audit of breast cancer patients. Patients who had received paclitaxel chemotherapy for breast cancer were characterized as having CIPN or not by clinical history/examination. Results: 256 women treated with paclitaxel at our institution were assessed for CIPN. Of these 133(52%) were premenopausal and 123(48%) postmenopausal at diagnosis. 22(8.6%) had preexisting diabetes mellitus. Of the 133 premenopausal women 97(72.9%) developed chemotherapy induced amenorrhea (CIA). The incidence of CIPN was 23.1% in persistently premenopausal patients 47.4% in patients with CIA and 57.7% in postmenopausal patients. In patients with DM 81.8% had CIPN. In a multivariate logistic regression model, increasing age (continuous variable RR=1.04 95%CI 1.02-1.08 p=0.001) DM (RR=4.39 95% CI 1.42-13.38 p=0.01) and postmenopausal/CIA status (RR=2.48 95% CI 1.05-5.88 p=0.03) were risk factors for CIPN. Because patients developed CIA at variable times and circulating progesterone levels at the time of neurotoxin insult maybe variable in them such patients were excluded in the second model, which included only patients with continuing menses (n=36) and postmenopausal at diagnosis (n=123). In the latter model postmenopausal status (RR=3.5 95%CI 1.18-10.39 p=0.02) and DM (RR=6.8 95%CI 1.44-31.82 p=0.01) were associated with CIPN but increasing age (RR=1.03 95% CI 0.98-1.07 p=0.21) was not. Conclusions: These results suggest a neuroprotective effect of premenopausal status, possibly related to higher circulating levels of progesterone. We hypothesize that progesterone administration prior to taxane chemotherapy may protect against CIPN. This will be tested in a RCT.

Sign in / Sign up

Export Citation Format

Share Document