Chemotherapy induced peripheral neuropathy. Case reports
Neuropatia periférica induzida pela quimioterapia. Relato de casos
Pedro Miguel Parreira da Silva; Vanessa Capelo Feijão; Maria Teresa Gonzalez Fontinhas
Abstract
BACKGROUND AND OBJECTIVES: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect reported by patients receiving cancer treatment, and it can affect treatment success, patient outcomes, and quality of life. CIPN typically begins with symmetrical progressive sensory alterations of the hands and feet in a stocking-gloving distribution. Currently, there is no standard treatment or intervention for the prevention, mitigation, or management of CIPN.
CASES REPORT: This study represents the activity of the Pain Multidisciplinary Unit of Hospital Santa Maria in Lisbon from 2018 to 2023, specifically on oncologic patients with chemotherapy-induced peripheral neuropathy. In total, this unit observed 57 patients, 43.9% had colon/rectum cancer, 28.1% hematological, 21.1% breast, 3.5% gastric, 1.8% ovarian and 1.8% lung. The most frequent chemotherapeutic agent used was oxaliplatin (40.4%), followed by capecitabine (24.6%) and paclitaxel (22.8%). The most prescribed combination of chemotherapy agents was capecitabine with oxaliplatin, according to the CAPOX protocol. The multidisciplinary unit, in conjunction with the oncology department, has set a new procedure in which patients receiving chemotherapy with one of the known agents linked with CIPN wear a pair of frozen gloves and socks. Three patients have undergone this prevention method, none of the patients has reported symptoms of CIPN.
CONCLUSION: This study contributes to draw attention to this important and limiting condition, and it also contributes to gather evidence on preventive measures that reduce the incidence of CIPN.
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Resumo
JUSTIFICATIVA E OBJETIVOS: A neuropatia periférica induzida por quimioterapia (NPIQ) é um efeito adverso comum relatado por pacientes sob terapêutica antineoplásica e pode afetar o sucesso do tratamento, os resultados e a sua qualidade de vida. A NPIQ começa com alterações sensoriais progressivas simétricas das mãos e dos pés, em distribuição em meia e luva. Atualmente, não existe tratamento ou terapêutica preventiva para a NPIQ.
RELATO DOS CASOS: Este estudo representa a atividade da Unidade Multidisciplinar de Dor do Hospital Santa Maria em Lisboa entre 2018 e 2023, especificamente em pacientes oncológicos com NPIQ. No total, esta unidade observou 57 pacientes, 43,9% tinham câncer do cólon/reto, 28,1% hematológico, 21,1% de mama, 3,5% gástrico, 1,8% câncer do ovário e 1,8% pulmão. O fármaco quimioterápico mais utilizado foi a oxaliplatina (40,4%), seguida pela capecitabina (24,6%) e paclitaxel (22,8%). A combinação de fármacos quimioterápicos mais prescrita foi capecitabina com oxaliplatina (CAPOX) (22,8%). A unidade multidisciplinar, em conjunto com o departamento de oncologia, estabeleceu um novo procedimento, no qual os pacientes que recebem quimioterapia com um dos agentes conhecidos ligados à NIPQ usaram um par de luvas e meias geladas. 3 pacientes foram submetidos a este método de prevenção e nenhum dos pacientes referiu sintomas de NPIQ.
CONCLUSÃO: O presente estudo contribuiu para alertar para esta doença importante e limitante, e reunir evidências sobre medidas preventivas que reduzem a incidência de NPIQ.
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References
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Submitted date:
04/02/2024
Accepted date:
09/03/2024