Effects of transcutaneous electrical nerve stimulation on chemotherapy-induced peripheral neuropathy symptoms (CIPN): a preliminary case-control study

Abstract

[Purpose] The aim of this double-blind, randomized and placebo-controlled study is to investigate the effects of Transcutaneous Electrical Nerve Stimulation for reducing the side effects of Chemotherapy-induced Peripheral Neuropathy in cancer patients undergoing chemotherapy with oxaloplatin or paclitaxel. [Subjects and Methods] Twenty-four patients were randomly allocated into two groups: active or placebo stimulation. All patients were assessed for pain, numbness/tingiling, frequency of symptoms, and quality of life. The transcutaneous Electrical Nerve Stimulation device was applied daily with modulating frequencies ranging between 7 Hz and 65 Hz in distal limb regions during three cycles of chemotherapy (45 days). The other stimulation parameters were: pulse duration of 200 μsec, intensity at the highest tolerable level, and increases in intensity when it diminished. [Results] The data showed no difference between active or placebo groups in terms of pain, numbness/tingling, frequency of symptoms or impact on daily life activities. [Conclusion] These results suggest that Transcutaneous Electrical Nerve Stimulation applied in the frequency variation mode was not proven to be effective to improve the symptoms of Chemotherapy-induced Peripheral Neuropathy during chemotherapy cycles. There was no worsening of symptoms in subsequent cycles of the onset of symptoms of the disease.

Systematic review of the effectiveness of self-initiated interventions to decrease pain and sensory disturbances associated with peripheral neuropathy

“…Studies were identified that assessed the following selfinitiated strategies: massage and hot baths (within a single study [59]), meditation [60,62,63], exercise [61,[64][65][66][67][68], and TENS [69][70][71][72][73][74]. The TENS interventions were included because in some settings this treatment is initiated by patients themselves (i.e., TENS machines are available for purchase over the counter in the United States [US], some European countries, and Australia).…”

“…No cold/ice pack or magnet studies were identified that fit the criteria for inclusion in this review. Seven of the 16 studies were conducted in the US [60-62, 64, 65, 69, 72], with the remaining nine conducted in South Korea [59,67], Germany [70,74], India [66], Canada [63], Egypt [71], Australia [68], and Brazil [73]. Nine of the 16 studies involved randomized controlled trial designs [60, 62, 63, 66, 69-71, 73, 74].…”

“…PN arose from a variety of disease and treatment-related etiologies, including CIPN [59,60,68,72,73], DPN [61-64, 66, 67, 69-71, 74], and CIDN [65]. The mean age of the patients ranged from a low of 49.5 years [73] to a high of 74.6 years [62]. Nine of the 16 studies had more than 50% female patients, with one study reporting that 88.5% of the patients were female [60].…”

“…Studies varied considerably in their reported attrition rates, from a low of 9% [63,65] to a high of 37% [64]. Four studies did not report attrition rates [69,71,73,74]. Table 6 summarizes the potential bias across the identified studies.…”

Evidence Based Complementary Approaches in the Management of Chemotherapy-Induced Peripheral Neuropathy in Cancer Patients

“…TENS uygulaması 15 günlük periyodlar şeklinde her gün, günde 60 dk olacak şekilde 3 siklus yapılmış ve nöropati semptomlarında herhangi bir iyileşme sağlamadığı görülmüştür. (42) EEG nörofeedback in değerlendirildiği bir çalışmada ise uygulama haftada 2 kez olacak şekilde toplam 20 seans uygulanmış ve nöropati semptomlarını azaltmada etkili olduğu EEG sonuçlarıyla tespit edilmiştir. (43)…”