Laser acupuncture attenuates oxaliplatin-induced peripheral neuropathy in patients with gastrointestinal cancer: a pilot prospective cohort study.
BACKGROUND
Oxaliplatin is a platinum compound that is widely used in the treatment of some solid tumours. Oxaliplatin-induced peripheral neuropathy (OIPN) in the upper and lower extremities is the major adverse side effect and represents the main dose-limiting factor of this drug. The aim of this single-arm study was to evaluate the feasibility and effects of laser acupuncture (LA) in the treatment of OIPN in patients with advanced gastrointestinal cancers.


METHODS
17 gastrointestinal cancer survivors (14 colorectal and 3 gastric cancers), who had been treated with oxaliplatin-based chemotherapies, were recruited. Low-level laser stimulation (50 mW) bilaterally at PC6, PC7, PC8, P9, LU11, SP6, KI3, BL60, KI1, and KI2 was administered for 20 min/point for 12 sessions over 4 weeks. The pain quality assessment scale (PQAS), chemotherapy-induced neurotoxicity questionnaire (CINQ), oxaliplatin-specific neurotoxicity scale (OSNS), quantitative touch-detection threshold (using von Frey filaments), and cold-triggered pain withdrawal latency (using the cold-water immersion test) were measured before and after completion of the 12 treatment sessions.


RESULTS
PQAS, CINQ, and OSNS scores, as well as touch-detection threshold and cold-trigger pain withdrawal latency all improved significantly after LA in the cancer patients with OIPN (p<0.05). LA significantly relieved both oxaliplatin-induced cold and mechanical allodynia and also decreased the incidence and severity of neurotoxicity symptoms in the patients' upper and lower extremities and impact on their daily activities (all p<0.05).


CONCLUSIONS
Following treatment with LA, neurotoxicity symptoms were significantly improved in cancer patients with OIPN. Further randomised controlled trials are needed to evaluate the role of LA as a therapeutic option in the management of OIPN.
Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan.
Yueh-Ling
YL
Hsieh
Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan.
Li-Wei
LW
Chou
Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital Chung Shing Branch, Taichung, Taiwan.
Shao-Fu
SF
Hong
Nursing Department, Chung Shan Medical University Hospital, Taichung, Taiwan.
Fei-Chi
FC
Chang
Department of Internal Medicine, Division of Medical Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan.
Szu-Wen
SW
Tseng
School of Medicine, Chung Shan Medical University, Taichung, Taiwan Department of Surgery, Division of Colon and Rectum, Chung Shan Medical University Hospital, Taichung, Taiwan.
Chi-Chou
CC
Huang
Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan.
Ching-Hsiang
CH
Yang
Department of Physical Medicine and Rehabilitation, Cheng Ching General Hospital, Taichung, Taiwan.
Chen-Chia
CC
Yang
Department of Physical Medicine and Rehabilitation, Cheng Ching General Hospital, Taichung, Taiwan.
Wei-Feng
WF
Chiu
D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000009:adverse effects*; D000077150:Oxaliplatin; D010146:Pain / Q000209:etiology; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000150:complications / Q000628:therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin
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