Журнал «Практическая онкология» Том 6, №2, 2023

Периферична нейропатія (ПН), спричинена хіміотерапією, є поширеним побічним ефектом терапії раку, який може мати глибокий вплив на якість життя та виживання. Частота виникнення ПН залежить від хіміотерапевтичного засобу, дози та тривалості впливу. Найчастіше засобами, що індукують ПН, є препарати платини, особливо цисплатин і оксаліплатин, таксани та алкалоїди барвінку. Завдяки успіхам протипухлинної терапії очікується, що кількість вилікуваних пацієнтів зростатиме. Отже, тривала нейротоксичність є важливою проблемою для осіб, що отримували таке лікування, особливо з приводу раку молочної залози та/або товстої кишки. Крім того, периферична нейропатія, індукована хіміотерапією, може негативно впливати на результати лікування через вимушену зміну дози та/або передчасне припинення лікування. Однак, незважаючи на значну поширеність, ПН часто діагностується і лікується незадовільно. У цьому огляді буде розглянуто існуючі методи профілактики та лікування периферичної нейропатії, індукованої хіміопрепаратами.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer therapy that can have a profound impact on quality of life and survival. The frequency of CIPN depends on the chemotherapeutic agent, dose, and duration of exposure. The agents that most often cause peripheral neuropathy are the platinum drugs, especially cisplatin and oxaliplatin, taxanes and vinca alkaloids. Thanks to advances in anticancer treatment, the number of cancer survivors is expected to increase. Thus, long-term neurotoxicity is a significant concern for individuals undergoing such treatment, especially those who received therapy for breast and/or colon cancer. In addition, chemotherapy-induced peripheral neuropathy may adversely affect treatment outcomes due to forced dose changes and/or premature discontinuation of treatment. However, despite its high prevalence, CIPN often remains an underdiagnosed and undertreated phenomenon. This review will address current methods for the prevention and treatment of chemotherapy-induced peripheral neuropathy.

периферична нейропатія; кріотерапія; компресійна терапія; дулоксетин; габапентиноїди; акупунктура

peripheral neuropathy; cryotherapy; compression therapy; duloxetine; gabapentinoids; acupuncture

1. Pike C.T., Birnbaum H.G., Muehlenbein C.E., Pohl G.M., Natale R.B. Healthcare costs and workloss burden of patients with chemotherapy-associated peripheral neuropathy in breast, ovarian, head and neck, and nonsmall cell lung cancer. Chemotherapy Research and Practice. 2012. 2012. 913848. doi: 10.1155/2012/913848.
2. Mols F., Beijers T., Vreugdenhil G., van de Poll-Franse L. Chemotherapy-induced peripheral neuropathy and its association with quality of life: a systematic review. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 2014. 22(8). 2261-2269. doi: 10.1007/s00520-014-2255-7.
3. Zajączkowska R., Kocot-Kępska M., Leppert W., Wrzosek A., Mika J., Wordliczek J. Mechanisms of chemotherapy-induced peri–pheral neuropathy. International Journal of Molecular Sciences. 2019. 20(6). 1451. doi: 10.3390/ijms20061451.
4. Bandla A., Sundar R., Liao L.-D., Sze Hui Tan S., Lee –S.-C., Thakor N.V., Wilder-Smith E.P.V. Hypothermia for preventing chemotherapy-induced neuropathy — a pilot study on safety and tole–rability in healthy controls. Acta Oncologica (Stockholm, Sweden). 2016. 55(4). 430-436. doi: 10.3109/0284186X.2015.1075664.
5. Beijers A.J.M., Bonhof C.S., Mols F., Ophorst J., de Vos-Gee–len J., Jacobs E.M.G., Vreugdenhil G. Multicenter randomized controlled trial to evaluate the efficacy and tolerability of frozen gloves for the prevention of chemotherapy-induced peripheral neuropathy. Annals of Oncology. 2020. 31(1). 131-136. doi: 10.1016/j.annonc.2019.09.006.
6. Chitkumarn P., Rahong T., Achariyapota V. Efficacy of Siriraj, in-house-developed, frozen gloves for cold therapy reduction of chemotherapy-induced peripheral neuropathy in gynecological cancer patients: randomized controlled trial. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 2022. 30(6). 4835-4843. doi: 10.1007/s00520-022-06890-1.
7. McCarthy A.L., Shaban R.Z., Gillespie K., Vick J. Cryothe–rapy for docetaxel-induced hand and nail toxicity: randomised control trial. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 2014. 22(5). 1375-1383. doi: 10.1007/s00520-013-2095-x.
8. Griffiths C., Kwon N., Beaumont J.L., Paice J.A. Cold therapy to prevent paclitaxel-induced peripheral neuropathy. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 2018. 26(10). 3461-3469. doi: 10.1007/s00520-018-4199-9.
9. Tsuyuki S., Yamagami K., Yoshibayashi H., Sugie T., Mizuno Y., Tanaka S., Inamoto T. Effectiveness and safety of surgical glove compression therapy as a prophylactic method against nanoparticle albumin-bound-paclitaxel-induced peripheral neuropathy. Breast (Edinburgh, Scotland). 2019. 47. 22-27. doi: 10.1016/j.breast.2019.06.008.
10. Sundar R., Bandla A., Tan S.S.H., Liao L.-D., Kumarakulasinghe N.B., Jeyasekharan A.D., Wilder-Smith E.P.V. Limb hypothermia for preventing paclitaxel-induced peripheral neuropathy in breast cancer patients: A pilot study. Frontiers in Oncology. 2016. 6. 274. doi: 10.3389/fonc.2016.00274.
11. Streckmann F., Kneis S., Leifert J.A., Baumann F.T., Kleber M., Ihorst G., Bertz H. Exercise program improves therapy-related side-effects and quality of life in lymphoma patients undergoing therapy. Annals of Oncology. 2014. 25(2). 493-499. doi: 10.1093/annonc/mdt568.
12. Kleckner I.R., Kamen C., Gewandter J.S., Mohile N.A., Heckler C.E., Culakova E., Mustian K.M. Effects of exercise during chemotherapy on chemotherapy-induced peripheral neuropathy: a multicenter, randomized controlled trial. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 2018. 26(4). 1019-1028. doi: 10.1007/s00520-017-4013-0.
13. Jennaro T.S., Fang F., Kidwell K.M., Smith E.M.L., Vangipuram K., Burness M.L., Hertz D.L. Vitamin D deficiency increases severity of paclitaxel-induced peripheral neuropathy. Breast Cancer Research and Treatment. 2020. 180(3). 707-714. doi: 10.1007/s10549-020-05584-8.
14. Smith E.M.L., Pang H., Cirrincione C., Fleishman S., Paskett E.D., Ahles T., Alliance for Clinical Trials in Oncology. Effect of duloxetine on pain, function, and quality of life among patients with chemotherapy-induced painful peripheral neuropathy: a randomized clinical trial. JAMA: The Journal of the American Medical Association. 2013. 309(13). 1359-1367. doi: 10.1001/jama.2013.2813.
15. Farshchian N., Alavi A., Heydarheydari S., Moradian N. Comparative study of the effects of venlafaxine and duloxetine on chemotherapy-induced peripheral neuropathy. Cancer Chemotherapy and Pharmacology. 2018. 82(5). 787-793. doi: 10.1007/s00280-018-3664-y.
16. Dhawan S., Andrews R., Kumar L., Wadhwa S., Shukla G. A randomized controlled trial to assess the effectiveness of muscle strengthening and balancing exercises on chemotherapy-induced peripheral neuropathic pain and quality of life among cancer patients. Cancer Nursing. 2020. 43(4). 269-280. doi: 10.1097/NCC.0000000000000693.
17. Zimmer P., Trebing S., Timmers-Trebing U., Schenk A., Paust R., Bloch W., Baumann F.T. Eight-week, multimodal exercise counteracts a progress of chemotherapy-induced peripheral neuropathy and improves balance and strength in metastasized colorectal cancer patients: a randomized controlled trial. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 2018. 26(2). 615-624. doi: 10.1007/s00520-017-3875-5.
18. Kneis S., Wehrle A., Müller J., Maurer C., Ihorst G., Gollhofer A., Bertz H. It’s never too late — balance and endurance training improves functional performance, quality of life, and alleviates neuropathic symptoms in cancer survivors suffering from chemotherapy-induced peripheral neuropathy: results of a randomized controlled trial. BMC Cancer. 2019. 19(1). 414. doi: 10.1186/s12885-019-5522-7.
19. Li K., Giustini D., Seely D. A systematic review of acupuncture for chemotherapy-induced peripheral neuropathy. Current Oncology (Toronto, Ont.). 2019. 26(2). e147-e154. doi: 10.3747/co.26.4261.
20. Chien T.-J., Liu C.-Y., Fang C.-J., Kuo C.-Y. The efficacy of acupuncture in chemotherapy-induced peripheral neuropathy: Systematic review and meta-analysis. Integrative Cancer Therapies. 2019. 18. 1534735419886662. doi: 10.1177/1534735419886662.
21. Kurt S., Can G. Reflexology in the management of chemotherapy induced peripheral neuropathy: A pilot randomized controlled trial. European Journal of Oncology Nursing: The Official Journal of European Oncology Nursing Society. 2018. 32. 12-19. doi: 10.1016/j.ejon.2017.11.001.
22. Noh G.O., Park K.S. Effects of aroma self-foot reflexology on peripheral neuropathy, peripheral skin temperature, anxiety, and depression in gynaecologic cancer patients undergoing chemotherapy: A randomised controlled trial. European Journal of Oncology Nursing: The Official Journal of European Oncology Nursing Society. 2019. 42. 82-89. doi: 10.1016/j.ejon.2019.08.007.
23. Loprinzi C., Le-Rademacher J.G., Majithia N., McMurray R.P., O’Neill C.R., Bendel M.A., Smith T.J. Scrambler therapy for chemotherapy neuropathy: a randomized phase II pilot trial. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 2020. 28(3). 1183-1197. doi: 10.1007/s00520-019-04881-3.
24. Smith T.J., Razzak A.R., Blackford A.L., Ensminger J., Saiki C., Longo-Schoberlein D., Loprinzi C.L. A pilot randomized sham-controlled trial of MC5-A scrambler therapy in the treatment of chronic chemotherapy-induced peripheral neuropathy (CIPN). Journal of Palliative Care. 2020. 35(1). 53-58. doi: 10.1177/0825859719827589.
25. Hammack J.E., Michalak J.C., Loprinzi C.L., Sloan J.A., Novotny P.J., Soori G.S., Johnson J.A. Phase III evaluation of nortriptyline for alleviation of symptoms of cis-platinum-induced periphe–ral neuropathy. Pain. 2002. 98(1–2). 195-203. doi: 10.1016/s0304-3959(02)00047-7.
26. Kautio A.-L., Haanpää M., Saarto T., Kalso E. Amitriptyline in the treatment of chemotherapy-induced neuropathic symptoms. Journal of Pain and Symptom Management. 2008. 35(1). 31-39. doi: 10.1016/j.jpainsymman.2007.02.043.
27. Rao R.D., Michalak J.C., Sloan J.A., Loprinzi C.L., Soori G.S., Nikcevich D.A., North Central Cancer Treatment Group. Efficacy of gabapentin in the management of chemotherapy-induced peripheral neuropathy: a phase 3 randomized, double-blind, placebo-controlled, crossover trial (N00C3). Cancer. 2007. 110(9). 2110-2118. doi: 10.1002/cncr.23008.
28. Mitchell P.L., Goldstein D., Michael M., Beale P., Friedlander M., Zalcberg J., Clarke S. Addition of gabapentin to a modified FOLFOX regimen does not reduce oxaliplatin-induced neurotoxi–city. Clinical Colorectal Cancer. 2006. 6(2). 146-151. doi: 10.3816/CCC.2006.n.032.
29. ClinicalTrials.gov. Prevention and treatment of chemotherapy-induced peripheral neuropathy in subjects with advanced colorectal cancer. http://clinicaltrials.gov/ct2/show/NCT00380874.
30. Nihei S., Sato J., Kashiwaba M., Itabashi T., Kudo K., Takahashi K. Efficacy and safety of pregabalin for oxaliplatin- and paclitaxel-induced peripheral neuropathy. Gan To Kagaku Ryoho. Cancer Chemotherapy. 2013. 40(9). 1189-1193. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24047777.
31. Sands S., Ladas E.J., Kelly K.M., Weiner M., Lin M., Ndao D.H., Bender J.G. Glutamine for the treatment of vincristine-induced neuropathy in children and adolescents with cancer. Suppor–tive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 2017. 25(3). 701-708. doi: 10.1007/s00520-016-3441-6.
32. Storey D.J., Colvin L.A., Mackean M.J., Mitchell R., Fleetwood-Walker S.M., Fallon M.T. Reversal of dose-limiting carboplatin-induced peripheral neuropathy with TRPM8 activator, menthol, enables further effective chemotherapy delivery. Journal of Pain and Symptom Management. 2010. 39(6). e2-4. doi: 10.1016/j.jpainsymman.2010.02.004.
33. Fallon M.T., Storey D.J., Krishan A., Weir C.J., Mitchell R., Fleetwood-Walker S.M., Colvin L.A. Cancer treatment-related neuropathic pain: proof of concept study with menthol — a TRPM8 agonist. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 2015. 23(9). 2769-2777. doi: 10.1007/s00520-015-2642-8.
34. Anand P., Elsafa E., Privitera R., Naidoo K., Yiangou Y., Donatien P., Misra P. Rational treatment of chemotherapy-induced peripheral neuropathy with capsaicin 8% patch: from pain relief towards disease modification. Journal of Pain Research. 2019. 12. 2039-2052. doi: 10.2147/JPR.S213912.
35. Prinsloo S., Novy D., Driver L., Lyle R., Ramondetta L., Eng C., Cohen L. The long-term impact of neurofeedback on symptom burden and interference in patients with chronic chemotherapy-induced neuropathy: Analysis of a randomized controlled trial. Journal of Pain and Symptom Management. 2018. 55(5). 1276-1285. doi: 10.1016/j.jpainsymman.2018.01.010.