Possibilities of therapy for neuropathic pain caused by chemo-induced polyneuropathy

Abstract

Background. In oncological practice, the study of neuropathic pain syndrome (NPS) in patients receiving chemotherapy (CT) is relevant. This disorder is accompanied by significant motor and autonomic disorders in the upper and lower extremities, which negatively affects the quality of life and daily activity of patients. Aim. To study the formation and evaluation of the effectiveness of NPS therapy in cancer patients with chemo-induced polyneuropathy (CIPN) at various stages of CT. Materials and methods. Sixty three oncological patients with different localization and stage of malignant neoplasm, having NPS and undergoing CT were examined. The average age was 56.3±9.4 years. Most often, patients had cancer of the stomach, breast, and ovaries. The main neurotoxic drugs used in the treatment of the tumor process were oxaliplatin, docetaxel, paclitaxel. The combination therapy was dominated by the carboplatin + paclitaxel scheme. As a therapy for NPS, 31 patients were prescribed a drug with antioxidant activity of azoximer bromide; 32 patients were prescribed duloxetine. The control group included 30 patients with cancer and CIPN who did not receive concomitant symptomatic therapy. Results. During the use of symptomatic therapy, a decrease in the severity of NPS was observed in all patients in the main groups compared with the control group. There was a significant decrease in sensitive disorders, especially in the duloxetine group. In the group of patients receiving azoximer bromide, it was also possible to stabilize the pathological process in the reflex sphere. Conclusion. CIPN and the associated NPS is an iatrogenic complication in cancer patients undergoing CT. Polyneuropathy not only significantly worsens the quality of life of patients, but also leads to a decrease in the effectiveness of treatment due to the need to correct therapeutic regimens. Therefore, early detection, proper monitoring and competent management of CIPN are important aspects of cancer patient care aimed at improving therapy outcomes and the overall well-being of patients.

Keywords

• neuropathic pain syndrome
• chemo-induced polyneuropathy
• chemotherapy
• cytostatic therapy
• antitumor therapy
• azoximer bromide
• duloxetine