Low-intensity focused ultrasound can safely and effectively treat chemo-induced peripheral neuropathy

Low-intensity focused ultrasound therapy (LIFU) may be a safe and effective treatment option for treating chemotherapy-induced peripheral neuropathy, but larger prospective studies are needed to develop a specific protocol. This is evident from research published in Pain Management.

Focused ultrasound has been of interest as a therapeutic method in recent years; high intensity focused ultrasound has been used in neurological disorders such as Parkinson’s disease and essential tremor. Low-intensity focused ultrasound promotes neural modulation and reduces the risk of tissue damage, but has not been fully explored in human studies.

In a single center, a retrospective analysis of 22 patients with cancer-related neuropathic pain, researchers evaluated the effects of focused, low-intensity ultrasound therapy at the Memorial Sloan-Kettering Cancer Center. Before treatment, the researchers recorded the patients’ initial pain using the numerical pain rating scale and their functional level.

Continue reading

The mean patient age was 64.91 ± 10.69 years (68.2% men). The most common cancer was lymphoma / leukemia (22.7% of patients), followed by breast cancer (18.2%). The patients’ underlying neuropathic pain was categorized as either chemotherapy-induced peripheral neuropathy or non-chemotherapy-induced peripheral neuropathy.

Each patient had an average of 3.59 focused, low-intensity ultrasound sessions (79 sessions total); Sessions can include therapy in one or more locations. The most common place of therapy was the foot, followed by the hand (92.4% and 7.6%, respectively).

Within the cohort, 86.4% of patients had more than one treatment session. Within this group, 2 patients could not be classified as responders or non-responders because they did not comment on the duration of their functional improvement. Of the remaining 17 patients, 76.5% responded to focused, low-intensity ultrasound therapy. Each patient in this group had a mean of 4.38 sessions (range 2 to 10).

In the entire cohort, the mean value on the numerical pain rating scale before treatment was 6.19; this was reduced to 3.43 after the treatment, which corresponds to a pain reduction of 44.59%. Of the 17 patients included in the analysis, 82.4% (n = 14) had chemotherapy-induced peripheral neuropathy; within this group, 85.7% were responders.

No patient underwent low-intensity, focused ultrasound experienced any side effects.

The limitations of the study include the inconsistent recurring treatment plan, the inconsistent use of the objective outcome parameters, the lack of inclusion of other validated pain scales, and the small sample size.

“Currently, the use of [low-intensity focused ultrasound] for cancer-related neuropathic pain is still in its infancy, ”they concluded. “Larger, prospective studies with a structured protocol need to be conducted to assess the effects of [low-intensity] focused ultrasound]for cancer-related neuropathic pain and to determine which treatment parameters and protocols are most beneficial. “

Disclosure: Some study authors stated links with biotech, pharmaceutical, and / or device companies. For a full list of the author’s disclosures, see the original reference.

reference

Patel AA, Zhukosvky M, Sidharthan S, Jotwani R, Rakesh N, Gulati A. Preliminary effects of the focused low intensity ultrasound treatment program for cancer-related neuropathic pain. Pain management. Published online June 9, 2021. doi: 10.2217 / pmt-2020-0099

This article originally appeared on Clinical Pain Advisor