Authors (including presenting author) :
Wong ST(1), Lo MT(1), Po WL(1), Siu LC(1), Tam NL(1), Ho LLL (2)
Affiliation :
(1) Department of Clinical Oncology, Queen Elizabeth Hospital
(2) Department of Obstetric & Gynecology, Queen Mary Hospital
Introduction :
Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy. More than 70 % of patients received paclitaxel experienced CIPN. Numbness, tingling and burning sensations with weakness or shooting pain in the extremities leading to impairment of fine motor skills, balance and coordination, inducing fall risk, with adverse effects on activities of daily living and quality of life. Ten Skilled hand exercise (TSHE), an acupressure exercise with pressure applied to specific acupoints over hands, eyes and ears through a series of hitting and clapping movements to dilate peripheral blood vessel and enhance microcirculation, was found to be effective in reducing patient-reported CIPN.
Objectives :
As paclitaxel is a commonly used anticancer drug for patients with gynecological cancer, a study was performed to determine the severity of CIPN of these patients. TSHE was the intervention to be tested for its effectiveness on prevention of CIPN for better patient wellbeing and quality of life.
Methodology :
Two groups of patients from two oncology centres were recruited by convenient sampling. The control group received standardized paclitaxel-based chemotherapy only while the interventional group received the same therapy with additional daily practice of TSHE. Functional Assessment of Cancer Therapy-Taxane (FACT-Taxane) was the tool employed for data collection. It is a self-report questionnaire consists of two parts: 1. FACT-General (FACT-G) to evaluate physical, social/family, emotional and functional well-beings of the patients. 2. FACT/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) to evaluate neurotoxicity subscales. The patients were invited to complete the questionnaire before starting treatment and then on day 1 of each cycle of treatment.
Result & Outcome :
Total 16 patients were recruited with eight in each group during the 4-month data collection. All patients completed 3 cycles of treatment. For symptoms of CIPN before chemotherapy, no significant difference was found between the two groups (FACT/GOG-Ntx score: Intervention: 63.38 ± 1.77 vs control: 61.00 ± 4.34, p = 0.869). However at the third cycle of treatment, symptoms of CIPN of the intervention group (58.12 ± 2.30) was significantly lower than the control group (44.25 ± 11.90) with p = 0.020. For the overall wellbeing, there was no significant difference before chemotherapy for the two groups (FACT-G score intervention: 71.38 ± 5.63 vs control 65.25 ± 9.5, p = 0.069). But at the third cycle, significant difference was found between intervention group (75.25 ± 8.43) and control group (62.75 ± 11.57) with p = 0.014. According to the data from this study, TSHE is effective to minimize the symptoms of CIPN and enhance the well-beings of gynecological cancer patients on paclitaxel-based chemotherapy. However, as the sample size of the study was small without randomization of patients with only three cycles of treatment being given, it is worthwhile to refine the study as a randomized control trial to further investigate the effectiveness of TSHE on CIPN.
