Treatment of Chemotherapy - Induced Peripheral Neuropathy: The Physicians Need Guidelines, the Patients Need Help

Abstract

The aim of the study was to verify the effectiveness of two methods of introducing standard CIPN-treatment drugs into the therapy. Materials and Methods: Group A included patients attending weekly appointments, while group B monthly. Standard treatment with amitriptyline, gabapentin (GAB), and oxycodone (OXY) was administered. In group A, the drugs were gradually introduced, while in group B - within one week. After a month and six months of treatment, the therapy effectiveness was assessed by examination of pain intensity (VAS), symptoms of peripheral neuropathy (sNCI-CTC), occurrence of tactile and brush allodynia, and the daily dose of GAB andOXY. Results: Pain intensity during the study decreased from 5.59 to 2.9 and 2.76 in group A, and from 5.07 to 2.52 and 2.81 in group B. The sNCI-CTC values declined too and were, respectively. 1.9; 1.48; 1.34 in group A and 1.93; 1.52; 1.44 in group B. Tactile allodynia occurred in 15; 5; 5 group A patients and 18; 6; 5 group B patients. Brush allodynia decreased in group A (9; 5; 5) and B (11; 6; 5). The daily GAB dose was 0; 951.72; 927.41 in group A and 900.0; 900.0; 1000.0 in group B. The daily OXY dose was 0; 21.72; 22.07 in group A and 20.0; 20.0; 27.04 in group B; a statistically significant difference was found in the final stage. The results do not allow recommendation of non-schematic treatment and they should be regarded as a preliminary study. Randomized trials are indispensable for assessment of advantages and drawbacks such treatment.