Abstract
High-dose capsaicin patch is effective in treatment of neuropathic pain in HIV-associated neuropathy and diabetic neuropathy. There are no studies assessing effectiveness of high-dose capsaicin patch in treatment of chemotherapy-induced peripheral neuropathy. We sought to determine the effectiveness of treatment of pain associated with chemotherapy-induced peripheral neuropathy with high-dose capsaicin patch. Our study group consisted of 18 patients with clinically confirmed oxaliplatin-induced neuropathy. Baseline characteristic including underling disease, received cumulative dose of neurotoxic agent, neuropathic symptoms, prior treatment and initial pain level were recorded. Pain was evaluated with Numeric Rating Scale prior to treatment with high-dose capsaicin and after 1.8 day and after 8 and 12 weeks after introducing treatment. Patients were divided into two groups accordingly to the amount of neurotoxic agent that caused neuropathy (high sensitivity and low sensitivity group). Most frequent symptoms of chemotherapy-induced neuropathy were: pain (88.89%), paresthesis (100%), sock and gloves sensation (100%) and hypoesthesis (100%). Initial pain level was 7.45 ± 1.14. Mean cumulative dose of oxaliplatin after which patients developed symptoms was 648.07 mg/m2. Mean pain level after 12 weeks of treatment was 0.20 ± 0.41. When examined according to high and low sensitivity to neurotoxic agent patients with low sensitivity had higher pain reduction, especially after 8 days after introducing treatment (69.55 ± 12.09 vs. 49.40 ± 20.34%; p = 0.02) and after 12 weeks (96.96 ± 5.56 vs. 83.93 ± 18.59%; p = 0.04). High-dose capsaicin patch is an effective treatment for pain associated with chemotherapy-induced neuropathy in patients treated with oxaliplatin. Patients with lower sensitivity to neurotoxic agents have better response to treatment and pain reduction.
Highlights
IntroductionChemotherapy-induced peripheral neuropathy (CIPN) is frequent complication of anti-neoplastic treatment with established frequency of 30–40% of patients undergoing 162 Page 2 of 5
Chemotherapy-induced peripheral neuropathy (CIPN) is frequent complication of anti-neoplastic treatment with established frequency of 30–40% of patients undergoing 162 Page 2 of 5Med Oncol (2017) 34:162 chemotherapy [1]
We described efficacy and safety of high-dose 8% capsaicin patch in treatment of patients with chemotherapy-induced peripheral neuropathy in patients treated with oxaliplatin-based chemotherapy for colon cancer
Summary
Chemotherapy-induced peripheral neuropathy (CIPN) is frequent complication of anti-neoplastic treatment with established frequency of 30–40% of patients undergoing 162 Page 2 of 5. Med Oncol (2017) 34:162 chemotherapy [1]. It significantly reduces quality of life and may be the cause of dose limitation or even cessation of treatment [2]. Promising concepts with very limited data consider topical menthol [10]. Fallon et al [10] recently described that topical menthol improves pain, walking ability, mood and sensation in patients with CIPN. Other concept studied by Gewandter et al [11] considered topical amitriptyline with ketamine, but received poor results in comparison with placebo
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