High-Intensity Pulsed Magnetotherapy in the Rehabilitation Programme of Patients with Chemotherapy-Induced Peripheral Polyneuropathy: a Prospective Randomized Clinical Study

Abstract

INTRODUCTION. Chemotherapy-induced peripheral polyneuropathy (CIPN) is one of the most frequent side effects caused by anticancer drugs, with a prevalence ranging from 19 % to 85 %. For effective multicomponent rehabilitation of patients with CIPN at different stages, a number of non-medicinal methods are recommended to improve the tolerance of chemotherapy and reduce the side effects of the antitumor treatment performed. AIM. Study of the effect of high-intensity pulsed magnetotherapy on clinical manifestations and microcirculation state in patients with CIPN. DESIGN. This is a randomized controlled study. SETTING. Randomization, organization of the study and data analysis were performed on the premises of the Department of Medical Rehabilitation in National Medical Research Centre for Rehabilitation and Balneology, Moscow, Russia. POPULATION. Sixty patients with CIPN were included in this study and were randomized by a simple random distribution method in a ratio of 1:1 into 2 groups of 30 people. METHODS. Sixty patients with CIPN four weeks after completion of chemotherapy were examined. The first group, the main group, included patients who received high-intensity pulsed magnetotherapy (HIPMT) in combination with drug therapy. In the second group (control group), the patients received only drug therapy. The EORTC-QLQ-C30 questionnaire (version 3) was used to assess the quality of life. The HADS scale was used to assess the severity of anxiety and depression symptoms. The state of microcirculation was assessed using laser Doppler flowmetry (LDF). The severity of CIPN was assessed according to the CTS-NCIC scale, version 3.0. RESULTS. According to the results of this study, there is a statistically significant difference in the scores on the EORTC-QLQ-C30 questionnaire (version 3), HADS scale and LDF data between the groups in favour of the group receiving HIPMT in combination with drug therapy. CONCLUSION. Based on the LDF study, significant disturbances at the microcirculatory level were detected for the first time in patients with CIPN. The obtained results convincingly demonstrate that the use of HIPMT in patients with CIPN leads not only to improvement of microcirculation in the extremities due to normalisation of arterial vessel tone, elimination of venous stasis and increase in the nutritive blood flow, but also has an analgesic effect, improves initially impaired sensitivity, and improves the quality of life of these patients. CLINICAL REHABILITATION IMPACT. The use of HIPMT in combination with drug therapy in patients with CIPN was more effective than drug therapy alone.