• The Journal of Internal Korean Medicine
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• v.41 no.3
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• pp.350-361
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• 2020

Objective: This study aimed to report the therapeutic effect of acupuncture on chemotherapy-induced peripheral neuropathy (CIPN). Methods: The articles were sourced from databases including PubMed, EMBASE, Cochrane Library, CNKI, CiNii, WHO ICTRP, JSOM, KMBASE, KISS, NDSL, and OASIS as of July 2019. The main search keywords were peripheral neuropathy and acupuncture, and only randomized controlled trials using acupuncture for therapeutic purposes were included. Cochrane's risk of bias was used to assess the risk of bias, and the Review Manager 5.3 program was used for meta-analysis. Results: Six studies with a total 394 participants were included. When combined treatment of acupuncture and usual care was compared with usual care alone, quality of life improved more significantly in the combination treatment group (SMD=-2.71, 95% CI: -5.01 to -0.41, P=0.02, I²=97%). The CIPN pain score was lower among the combination treatment group, but not to a significant degree (SMD=-2.55, 95% CI: -5.14 to 0.04, P<0.05, I²=98%). There were no severe side effects in any studies. Conclusion: Acupuncture combined with usual care may be considered to safely relieve CIPN pain and improve quality of life for cancer patients. However, as there are few randomized controlled trials studying the effect of acupuncture on CIPN, further well-designed research is needed.

• The Journal of Internal Korean Medicine
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• v.42 no.2
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• pp.104-113
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• 2021

Introduction: The aim of this study is to report on the effectiveness of Korean medicine to improve symptoms of chemotherapy-induced peripheral neuropathy (CIPN). Some patients are treated with medication, but medications may have no effect in some patients. Korean medicine treatments have been used in such patients, but few reports exist. Case Presentation: A 58-year-old female patient with CIPN reported symptoms of bilateral limb pain and tingling sensations as well as cold sensations in bilateral lower legs and hands, fatigue, and bilateral limb weakness. To reduce the patient's symptoms, we provided Korean medical treatment, including herbal medicine (Uchashinki-hwan), acupuncture, and moxibation. To evaluate the results of this treatment, we used a numeric rating scale (NRS), the manual muscle test (MMT), the National Cancer Institute Common Toxicity Criteria for Adverse Events (CTCAE), and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire about CIPN (EORTC-QLQ-CIPN20). After 49 days of treatment, the NRS scores decreased for bilateral limb pain and tingling, for bilateral lower leg and hand cold sensation, and for fatigue. The MMT results for the upper and lower extremities were improved. CTCAE Grade and EORTC QLQ-CIPN20 score were also decreased. Conclusion: According to these results, Korean medicine treatment may be considered an effective treatment for CIPN. Prospective studies are needed in the future to confirm and expand these findings.

• Journal of Digestive Cancer Research
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• v.11 no.1
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• pp.45-48
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• 2023

One of the most common side effects of chemotherapeutic agents is chemotherapy-induced peripheral neuropathy (CIPN). The occurrence of CIPN is increasing as the survival rate of patients with cancer improves and the cumulative dose or duration of neurotoxic drugs increases. Approximately 30-40% of patients receiving neurologically toxic drugs experience CIPN, which eventually increases the burden of medical expenses. However, preventive measures against CIPN have not yet been established. Clinical trials have tested various drugs for the management of neuropathic pain, but only duloxetine has shown any significant effect. Further studies should evaluate nonpharmaceutical treatments, such as exercise.

• Journal of Korean Biological Nursing Science
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• v.20 no.2
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• pp.55-66
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• 2018

Purpose: Peripheral neuropathy is common among colorectal cancer (CRC) patients who undergo oxaliplatin-based (OXL) chemotherapy. A pharmacogenetic approach can be used to identify patients at high-risk of developing severe neuropathy. This type of approach can also help clinicians determine the best treatment option and prevent severe neurotoxicity. The purpose of this study is to investigate the evidence of pharmacogenetic markers for OXL-induced peripheral neuropathy (OXIPN) in patients with CRC. Methods: A systematic literature search was conducted using the following databases up to December 2017: Pubmed, EMBASE, and CINAHL. We reviewed the genetic risk factors for OXIPN in observational studies and randomized controlled clinical trials (RCTs). All processes were performed independently by two reviewers. Results: Sixteen studies published in English between 2006 and 2017 were included in this review. A genome-wide association approach was used in one study and various candidate genes were tested, based on their functions (e.g., DNA damage or repair, ion channels, anti-oxidants, and nerve growth etc.). The genes associated with incidence or severity of OXIPN were ABCG2, GSTP1, XRCC1, TAC1, and ERCC1. Conclusion: This study highlighted the need and the importance of conducting pharmacogenetic studies to generate evidence of personalized OXIPN symptoms management. Additional studies are warranted to accelerate the tailored interventions used for OXIPN in patients with CRC (NRF-2014R1A1A3054386).

• Journal of Korean Physical Therapy Science
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• v.7 no.2
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• pp.559-565
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• 2000

This studies were to investigate the effects of low power Helium-Neon Infra-Red (He-Ne IR) laser on the healing of the peripheral neuropathy in diabetic rats. The twenty one Spraque-Dewley adult male rats were assigned to the 3 groups: the control group (7), the diabetic group (7) and the laser group (7). The diabetic group was induced with a single intravenous injection of 50mg/kg body weight streptozotocin dissolved to 0.01mol/L citrate buffer, pH 4.5. The experimental laser group was irradiated low power He-Ne IR laser for 5 minutes every day during 21 days to the diabetic group. The results were as follows: For on and two weeks with laser treatment, there were significantly increased the terminal latencies of the laser treatment group than those of diabetic group, but that was significantly decreased to be similar to the control group on the laser treatment group for three weeks. The change of the amplitude on the laser treatment groups for three weeks was significantly increased to be similar to normal group than that of the diabetic group. As the result, we thank that there were activately effected of lower power He-Ne IR laser on the heeling of the peripheral neurophathy in diabetic rats.

• Biomolecules & Therapeutics
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• v.22 no.5
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• pp.445-452
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• 2014

The purpose of this study was to investigate the therapeutic effects of DA-9801, an optimized extract of Dioscorea species, on diabetic peripheral neuropathy in a type 2 diabetic animal model. In this study, db/db mice were treated with DA-9801 (30 and 100 mg/kg, daily, p.o.) for 12 weeks. DA-9801 reduced the blood glucose levels and increased the withdrawal latencies in hot plate tests. Moreover, it prevented nerve damage based on increased nerve conduction velocity and ultrastructural changes. Decrease of nerve growth factor (NGF) may have a detrimental effect on diabetic neuropathy. We previously reported NGF regulatory properties of the Dioscorea genus. In this study, DA-9801 induced NGF production in rat primary astrocytes. In addition, it increased NGF levels in the sciatic nerve and the plasma of type 2 diabetic animals. DA-9801 also increased neurite outgrowth and mRNA expression of Tieg1/Klf10, an NGF target gene, in PC12 cells. These results demonstrated the attenuation of diabetic peripheral neuropathy by oral treatment with DA-9801 via NGF regulation. DA-9801 is currently being evaluated in a phase II clinical study.

• Journal of Korean Traditional Oncology
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• v.28 no.1
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• pp.33-44
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• 2023

목적: 항암유발말초신경병증은 암 환자가 겪는 흔한 항암 부작용이나 현재까지 효과적으로 알려진 치료법은 없다. 본 연구의 목적은 항암유발말초신경병증에 대한 침 치료와 가바펜틴의 병용 요법의 효과와 안전성을 평가하는 것이다. 방법: 항암유발말초신경병증을 겪고 있는 24명의 암 환자를 침 치료 단독군 (AG, acupuncture group)과 침과 가바펜틴의 병용요법군 (CG, combined acupuncture and gabapentin group)으로 무작위 배정하였다. 두 그룹 모두 침 치료는 주 3회, 4주간 수행하였다. 병용 요법군은 침 치료와 더불어 1일 900mg의 가바펜틴을 복용하도록 하였다. 치료 효과는 Neuropathic Pain Symptom Inventory (NPSI), visual analogue scale (VAS), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 items (EORTC-CIPN20)를 이용하여 측정하였다. 치료로 인한 부작용은 대상자가 방문할 때마다 조사하였다. 결과: 총 23명의 대상자(AG, n=12; CG, n=11)의 평가지표를 분석한 결과, 치료 4 주 후 침 치료 단독군은 NPSI 점수가 44.33±25.04에서 30.58±21.55으로 감소하였고, 병용 요법군은 30.55±25.59에서 18.64±19.42로 감소하였으며, 두 군 모두 통계적으로 유의미하게 감소하였다(p<0.001). VAS점수는 침 치료 단독군에서는 4.79±2.17 에서 3.42±2.49으로 감소하였고, 병용 요법군에서는 3.55±2.07에서 2.73±2.49 로 감소하였다(p<0.05). 치료 효과는 치료 완료 2주후까지 지속되었으며, 두 군간의 유의미한 차이는 없었다. EORTC-CIPN20은 침 치료 단독군은 30.27±18.87에서 20.84±16.35으로 감소하여(p<0.01), 두 군 모두에서 삶의 질이 향상되었다. 결론: 본 연구로 침 치료와 가바펜틴의 병용 요법이 항암유발말초신경병증 환자의 증상 및 삶의 질 개선에 효과적이며 안전한 치료법임을 확인하였다. 그러나 침 치료와 가바펜틴의 시너지 효과에 대해서는 확인 할 수 없었으며, 이를 확인하기 위해 추가적인 연구가 필요할 것으로 사료된다.

• Korean Journal of Adult Nursing
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• v.27 no.3
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• pp.358-366
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• 2015

Purpose: This study was aimed to identify the incidence and severity of chemotherapy-induced peripheral neuropathy (CIPN) among patients with hematologic malignancies and to examine the relationship between the quality of life (QOL) and CIPN. Methods: A total of 66 patients with CIPN-related symptoms participated in this study. Data were collected through self-reported questionnaires consisted of the European Organization for Research and Treatment of Cancer QLQ-C30 version 3.0 and the 16-item QLQ-CIPN20. Data were analyzed with SPSS/WIN20 for descriptive statistics using the Mann-Whitney and Kruskal-Wallis tests, and Spearman's rho. Results: The mean lower and upper extremity scale scores were 31.95 and 23.16 respectively for the 16-item QLQ-CIPN20. The mean QLQ-C30 subcategory scores were 46.84 for global health status, 58.72 for functional scales, and 34.85 for symptom scales. The CIPN-related lower extremity scale symptoms correlated negatively with the QOL subscales. There was no correlation between CIPN-related upper extremity symptoms and health-related QOL. Conclusion: Patients with hematologic malignancies treated with neurotoxic chemotherapeutic agents had CIPN-related symptoms in the lower extremities mainly, and their QOL functional subscale scores were relatively lower than those of other cancer patients. Interventions need to be developed for patients with hematologic malignancies to alleviate CIPN and enhance their QOL.

• Journal of Korean Academy of Nursing
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• v.48 no.2
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• pp.123-142
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• 2018

Purpose: This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN). Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses. Results: Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (p<.001). Massage and foot bath were also effective in reducing CIPN symptoms (d=-0.68; 95% CI=-1.05, -0.30; p<.001; $I^2=19%$).Exercises were effective in improving muscle strength and endurance(d=-0.55) and quality of life (d=-2.96), but they were not significantly effective in improving CIPN. Conclusion: Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.4
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• pp.460-463
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• 2014

Chemotherapy-induced peripheral neuropathy (CIPN) which is one of the common chemotherapy related toxicity poses a significant clinical challenge. Here we conducted a prospective pilot study to evaluate the efficacy of acupuncture on CIPN. Patients with CIPN were administered acupuncture procedure with continuation of previous conventional medication. Acupuncture procedures were conducted three times per week for 3 weeks. We assessed patients with Common Terminology Criteria for Adverse Events (CTCAE) v4.0, Visual Analog Scale (VAS), Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity (FACT/GOG-Ntx) at the time of baseline and every week after the acupuncture procedures. Total 5 patients were included and treated with acupuncture. CTCAE grades were the same of 2 in all patients. VAS mean value changed from 5.2 to 3.2, and FACT/GOG-Ntx total score that suggests the higher relates to better quality of life changed from 93.3 to 110 as mean value at the end of the 3rd week, though this index difference did not show any statistically significant difference. This pilot study suggests that acupuncture procedure may have a role for CIPN treatment. Launching a more larger and properly controlled study will be required to ascertain the efficacy of acupuncture.