Scrambler therapy for painful chemotherapy-induced peripheral neuropathy: Extending the evidence base.

Abstract

e24147 Background: Chemotherapy-induced peripheral neuropathy (CIPN) burdens patients. Six months after treatment, the incidence of CIPN ranges from 30-40%. Immunotherapies are less likely to cause peripheral neuropathies. The emergence of CIPN during treatment may require chemotherapy dose decrements, premature discontinuation of therapies, deconditioning, increased fall risk and other problems associated with increased morbidity and mortality. Medications for CIPN have limited efficacy. Methods: Scrambler Therapy was provided to 52 patients for CIPN-associated pain. Electrode pairs were placed along the sensory dermatome pathways linked to the areas of painful symptoms. Scrambler sessions lasted 35 minutes. Patients rated their pain before and after each Scrambler session on a 0-10 Visual-Analog Scale (VAS). Results: 1) 64% of patients were responders, defined as 30% or greater improvement in their pain scores. 52% of patients had 50% or more pain relief. 37% of patients were nonresponders, defined as 0-30% relief. 2) On average it took 4 sessions to achieve 30% improvement in pain. 3) Some statistically significant differences in analgesic response to Scrambler existed among groups based on what chemotherapy agent(s) they had received. Platinum-only patients demonstrated the least response, whereas patients who had received vinca alkaloids, only taxanes, and proteasome inhibitors showed the greatest magnitude relief. Conclusions: Our findings confirm and extend previous studies suggesting that Scrambler Therapy can be an efficacious treatment approach for painful symptoms of CIPN. Demographic and treatment characteristics of patients undergoing Scrambler Therapy for CIPN. Non-responders Partial Responders Full Responders Total Age 65 and over 11 (39.3%) 3 (10.7%) 14 (50%) 28 Under 65 8 (33.3%) 3 (12.5%) 13 (54.2%) 24 All ages 19 (36.5%) 6 (11.5%) 27 (52%) 52 Sex Male 11 (39.3%) 3 (10.7%) 14 (50%) 28 Female 8 (33.3%) 3 (12.5%) 13 (54.2%) 24 Baseline pain rating 4.8 ± 1.6 5.7 ± 1.2 5.6 ± 2.0 F = 1.0,P = 0.38 ST sessions completed 7.2 ± 2.7 7.2 ± 2.7 8.4 ± 2.1 F = 1.1,P = 0.34 Chemotherapy agent Platinum only 7 (58.3%) 2 (16.7%) 3 (25%) 12 Folate antimetabolites/vinca alkaloids/alkylating agents & stem cell 1 (9.1%) 2 (18.2%) 8 (72.7%) 11 Platinum and taxane 4 (40%) 0 6 (60%) 10 Proteasome inhibitors 2 (22.2%) 1 (11.1%) 6 (66.7%) 9 Immunotherapies 3 (50%) 1 (16.7%) 2 (33.3%) 6 Taxane only 1 (33.3%) 0 2 (66.7%) 3 Other 1 (100%) 0 0 1 Cancer diagnosis Blood/Myeloma 4 (25%) 2 (12.5%) 10 (62.5%) 16 Breast/Male breast 3 (30%) 1 (10%) 6 (60%) 10 Alimentary tract 3 (33.3%) 2 (22.2%) 4 (44.5%) 9 Genital/Urinary 2 (40%) 0 3 (60%) 5 Lung 3 (75%) 1 (25%) 0 4 Lymph/Thymus 1 (25%) 0 3 (75%) 4 Head & Neck 2 (100%) 0 0 2 Muscle 0 0 1 (100%) 1 Skin/Melanoma 1 (100%) 0 0 1 For the variable “baseline pain rating” and “ST sessions completed”, last column includes the ANOVA test statistic and p-value for the group comparison.