Quality of Life Estimate of Patients with Chemotherapy-Induced Distal Polyneuropathy after High-Intensity Pulsed Magnetic Therapy: a Randomized Clinical Study

N. G. Kulikova, A. D. Fesyun, T. Konchugova, D. Kulchitskaya, O. V. Yurova, Alexey Е. Kudryavtsev
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Abstract

INTRODUCTION. The development of peripheral polyneuropathy in cancer patients after chemotherapy has a high prevalence and represents an important medical and social problem. Currently, a number of physiotherapeutic methods are used to treat peripheral polyneuropathy induced by chemotherapy (PPIC). AIM. To study clinical efficacy of high-intensity pulsed magnetic therapy in patients with PPIC according to indicative quality of life indicators. MATERIALS AND METHODS. 90 patients with PPIC were included in the study. The mean age of the patients was 57.3 ± 5.3 years. Two groups were formed by randomization method: control group patients (n = 45) received standard drug therapy; main group patients (n = 45) received 10 high-intensity pulsed magnetic therapy (HIPMT) procedures every other day against the background of standard therapy. We analyzed clinical complaints, pain syndrome according to VAS, EORTC QLQ-CIPN20 scale scores, and quality of life indicators according to SF-36 questionnaire in patients with PPIC on day 20 after the start of clinical intervention. RESULTS. After the conducted course of high-intensity pulsed magnetic therapy there was a significant increase in the cohort of patients with a lower degree of severity of PPIC, the proportion of patients with PPIC belonging to subgroups 0–1 degree of severity increased by 6.6 % (p 0.01). Initial limb pain syndrome according to the VAS system in patients with PPIC in the main group decreased from 6.8 ± 1.2 to 2.4 ± 0.8 points (p 0.05). In the control group VAS changed from 7.0 ± 1.1 to 6.3 ± 0.9 scores (p 0.05), which was not statistically significant. It was found that inclusion of high-intensity pulsed magnetic therapy in the treatment program allows for more significant positive changes in sensory, motor and autonomous-vegetative manifestations of PPIC. According to the SF-36 scale, statistically significant differences were found in relation to physical functioning in patients of the main group. There was also an improvement in the indicators reflecting the social components of the quality of life in patients who received the course effect of (HIPMT) from 61 [58.6; 64.4] points to 66 [59.7; 70.0] points by 8.2 % (p 0.05). Psychological health in the main group improved by 17.02 % (p 0.01). In the control group, there were no significant shifts on any of the scales (p 0.05). CONCLUSION. The use of the high-intensity pulsed magnetic therapy procedures proved to be highly effective in correcting the main indicators of the quality of life of patients with PPIС.
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高强度脉冲磁疗法后化疗诱发远端多发性神经病患者的生活质量评估:一项随机临床研究
简介癌症患者化疗后出现外周多发性神经病的发病率很高,是一个重要的医疗和社会问题。目前,有多种物理治疗方法可用于治疗化疗诱发的外周多发性神经病(PPIC)。 目的根据生活质量指标,研究高强度脉冲磁疗对 PPIC 患者的临床疗效。 研究共纳入 90 名 PPIC 患者。患者的平均年龄为(57.3 ± 5.3)岁。通过随机方法分为两组:对照组患者(45 人)接受标准药物治疗;主要组患者(45 人)在标准治疗的基础上,每隔一天接受 10 次高强度脉冲磁疗(HIPMT)。我们分析了临床干预开始后第 20 天 PPIC 患者的临床主诉、VAS 疼痛综合征、EORTC QLQ-CIPN20 量表评分以及 SF-36 问卷的生活质量指标。 结果在进行高强度脉冲磁疗后,PPIC 严重程度较低的患者群明显增加,属于严重程度 0-1 亚组的 PPIC 患者比例增加了 6.6 %(P 0.01)。根据 VAS 系统,主要组 PPIC 患者的初始肢体疼痛综合征从 6.8 ± 1.2 分降至 2.4 ± 0.8 分(P 0.05)。对照组的 VAS 从 7.0 ± 1.1 分降至 6.3 ± 0.9 分(P 0.05),无统计学意义。研究发现,在治疗方案中加入高强度脉冲磁疗法可使 PPIC 的感觉、运动和自主-植物神经表现发生更显著的积极变化。根据 SF-36 量表,主要治疗组患者的身体功能在统计学上有显著差异。接受(HIPMT)疗程的患者在反映生活质量的社会组成部分的指标方面也有改善,从 61 [58.6; 64.4] 分提高到 66 [59.7; 70.0] 分,提高了 8.2%(P 0.05)。主要组的心理健康水平提高了 17.02 %(P 0.01)。对照组的任何量表均无明显变化(P 0.05)。 结论。事实证明,使用高强度脉冲磁疗程序对改善颅内压增高症患者生活质量的主要指标非常有效。
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