Hand therapy interventions for the prevention of chemotherapy-induced peripheral neuropathy of the hands in patients with pancreatic cancer

Oncologist. 2024 Dec 6;29(12):1095-e1778. doi: 10.1093/oncolo/oyae285.

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN), a common problem, can impair function and quality of life in patients, potentially limiting chemotherapy and adversely affecting outcomes.

Methods: This trial compared investigational hand therapy intervention (Investigational) compared with a traditional occupational therapy approach (Traditional) to prevent CIPN in patients with pancreatic cancer receiving gemcitabine and albumin-bound paclitaxel containing regimens.

Results: forty-nine patients were enrolled with 40 evaluable for statistical analysis (21 Investigational/19 Traditional). CIPN in the hands was reported in 6 patients (28.6%) in Investigational, and 4 (21.1%) in Traditional P = .721. Kaplan-Meier analysis showed a mean time-to-event of 76.0 days (90% CI: 68.5, 83.6), and 75.8 (90% CI: 68.5, 83.2) days respectively, P = .614. Fifteen patients in each group (78.9% Traditional, 71.4% in Investigational) were censored as they did not develop CIPN. No correlation was found between CIPN risk and age, sex, BMI, disease stage, performance status, or chemotherapy dose.

Conclusion: Seventy-four percent of patients receiving gemcitabine, albumin-bound paclitaxel, and cisplatin did not develop CIPN of the hands by day 84. There was no statistical difference in time to onset of CIPN between the two groups. Early adaption of occupational therapy may prevent early onset CIPN in chemotherapy patients.

Clinicaltrials.gov identifier: NCT05374876.

Keywords: chemotherapy-induced peripheral neuropathy; gemcitabine + albumin-bound paclitaxel; gemcitabine + albumin-bound paclitaxel + cisplatin; pancreatic neoplasms; physical and rehabilitation medicine.

MeSH terms

  • Adult
  • Aged
  • Albumins / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Deoxycytidine* / adverse effects
  • Deoxycytidine* / analogs & derivatives
  • Deoxycytidine* / therapeutic use
  • Female
  • Gemcitabine*
  • Hand
  • Humans
  • Male
  • Middle Aged
  • Occupational Therapy / methods
  • Paclitaxel* / adverse effects
  • Pancreatic Neoplasms* / drug therapy
  • Peripheral Nervous System Diseases* / chemically induced
  • Peripheral Nervous System Diseases* / prevention & control

Substances

  • Paclitaxel
  • Deoxycytidine
  • Gemcitabine
  • Albumins

Associated data

  • ClinicalTrials.gov/NCT05374876