Characterization and diagnostic evaluation of chronic polyneuropathies induced by oxaliplatin and docetaxel comparing skin biopsy to quantitative sensory testing and nerve conduction studies

Cancer and its treatment exert a heavy psychological and physical toll. Of the myriad symptoms which result, pain is common, encountered in between 30% and 60% of cancer survivors. Pain in cancer survivors is a major and growing problem, impeding the recovery and rehabilitation of patients who have beaten cancer and negatively impacting on cancer patients' quality of life, work prospects and mental health. Persistent pain in cancer survivors remains challenging to treat successfully. Pain can arise both due to the underlying disease and the various treatments the patient has been subjected to. Chemotherapy causes painful chemotherapy-induced peripheral neuropathy (CIPN), radiotherapy can produce late effect radiation toxicity and surgery may lead to the development of persistent post-surgical pain syndromes. This review explores a selection of the common causes of persistent pain in cancer survivors, detailing our current understanding of the pathophysiology and outlining both the clinical manifestations of individual pain states and the treatment options available.

show abstract

“…83 Despite the lack of validation in CIPN, biopsy may have utility when compared to other diagnostic modalities. 84 …”

Section: Detection/diagnosismentioning

confidence: 99%

Pain in cancer survivors

Brown

Ramirez

Farquhar-Smith

2014

British Journal of Pain

View full text Add to dashboard Cite

show abstract

“…Those therapies most likely to produce CIPN include cisplatin [3] oxaliplatin [4,5], vincristine [6,7], paclitaxel [8] and bortezomib [1]. Each of these agents works to kill cancerous cells in differing ways and produces various rates of CIPN.…”

mentioning

confidence: 99%

Mechanisms Involved in the Development of Chemotherapy-Induced Neuropathy

2015

View full text Add to dashboard Cite

SUMMARY Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and painful condition seen in patients undergoing treatment with common agents such as vincristine, paclitaxel, oxaliplatin and bortezomib. The mechanisms of this condition are diverse, and include an array of molecular and cellular contributions. Current research implicates genetic predispositions to this condition, which then may influence cellular responses to chemotherapy. Processes found to be influenced during CIPN include increased expression of inflammatory mediators, primarily cytokines, which can create cascading effects in neurons and glia. Changes in ion channels and neurotransmission, as well as changes in intracellular signaling and structures have been implicated in CIPN. This review explores these issues and suggests considerations for future research.

show abstract

“…The perception of pinprick pain intensity is related to activity in A- δ fiber nociceptors [35]. Krøigård et al observed in patients with CIPN caused by oxaliplatin and docetaxel that mechanical detection threshold measured with von Frey hairs was more affected as the cold detection threshold [36]. These results indicate that CIPN affects both small and large nerve fibers.…”

Section: Discussionmentioning

confidence: 99%

Intravenous Lidocaine: Old-School Drug, New Purpose—Reduction of Intractable Pain in Patients with Chemotherapy Induced Peripheral Neuropathy

Heuvel

Wal

Smedes

et al. 2017

Pain Research and Management

View full text Add to dashboard Cite

Background. Treatment of intractable pain due to chemotherapy induced peripheral neuropathy (CIPN) is a challenge. Intravenous (iv) lidocaine has shown to be a treatment option for neuropathic pain of different etiologies. Methods. Lidocaine (1.5 mg/kg in 10 minutes followed by 1.5 mg/kg/h over 5 hours) was administered in nine patients with CIPN, and analgesic effect was evaluated during infusion and after discharge. The immediate effect of lidocaine on pressure pain thresholds (PPT) and the extent of the stocking and glove distribution of sensory abnormalities (cold and pinprick) were assessed. Results. Lidocaine had a significant direct analgesic effect in 8 out of 9 patients (P = 0.01) with a pain intensity difference of >30%. Pain reduction persisted in 5 patients for an average of 23 days. Lidocaine did not influence mean PPT, but there was a tendency that the extent of sensory abnormalities decreased after lidocaine. Conclusion. Iv lidocaine has direct analgesic effect in CIPN with a moderate long-term effect and seems to influence the area of cold and pinprick perception. Additional research is needed, using a control group and larger sample sizes to confirm these results.

show abstract

Characterization and diagnostic evaluation of chronic polyneuropathies induced by oxaliplatin and docetaxel comparing skin biopsy to quantitative sensory testing and nerve conduction studies

Abstract: Chemotherapy-induced peripheral neuropathy after oxaliplatin or docetaxel treatment is a clinically sensory, axonal neuropathy affecting only small nerve fibres in some patients. NCS are often normal, whereas QST and skin biopsy have a higher diagnostic sensitivity.

Cited by 85 publications

References 24 publications

Pain in cancer survivors

Pain in cancer survivors

Mechanisms Involved in the Development of Chemotherapy-Induced Neuropathy

Intravenous Lidocaine: Old-School Drug, New Purpose—Reduction of Intractable Pain in Patients with Chemotherapy Induced Peripheral Neuropathy

Contact Info

Product

Resources

About