Low-intensity focused ultrasound therapy (LIFU) may be a safe and effective treatment option to manage chemotherapy-induced peripheral neuropathy, but larger prospective studies are needed to devise a specific protocol. This is according to research results published in Pain Management.

Focused ultrasound has been of interest in the last several years as a therapeutic modality; high-intensity focused ultrasound has been used for neurologic disorders such as Parkinson disease and essential tremor. Low-intensity focused ultrasound promotes neuronal modulation and mitigates the risk of tissue damage but has not been fully evaluated in human studies.

In a single center, retrospective analysis of 22 patients with cancer-related neuropathic pain, researchers evaluated the effect of low-intensity focused ultrasound therapy at Memorial Sloan-Kettering Cancer Center. Before treatment, researchers recorded patients’ baseline pain using the numeric pain rating scale as well as their level of function.


Continue Reading

The mean patient age was 64.91±10.69 years (68.2% men). The most common cancer was lymphoma/leukemia (22.7% of patients) followed by breast cancer (18.2%). Patients’ underlying neuropathic pain was categorized as either chemotherapy-induced peripheral neuropathy or non-chemotherapy-induced peripheral neuropathy.

Each patient underwent a mean of 3.59 low-intensity focused ultrasound sessions (total sessions, 79); sessions could include therapy to 1 or multiple locations. The most common location for therapy was the foot, followed by the hand (92.4% and 7.6%).

Within the cohort, 86.4% of patients underwent more than 1 treatment session. Within this group, 2 patients could not be classified as responders or nonresponders because they did not comment on the duration of their functional improvement. Among the remaining 17 patients, 76.5% were responders to low-intensity focused ultrasound therapy. Each patient in this group underwent a mean of 4.38 sessions (range, 2 to 10).

In the whole cohort, the mean pretreatment numerical pain rating scale score was 6.19; this was reduced to 3.43 after treatment, or a 44.59% reduction in pain. Among the 17 patients who were included in the analysis, 82.4% (n=14) had chemotherapy-induced peripheral neuropathy; within this group, 85.7% were responders.

No patients who underwent low-intensity focused ultrasound experienced adverse effects.

Study limitations include the inconsistent recurrent treatment schedule, inconsistent utilization of the objective outcome measures, a lack of incorporation of other validated pain scales, and the small sample size.

“Currently, the use of [low-intensity focused ultrasound] for cancer-related neuropathic pain is in its infancy stage,” they concluded. “Larger, prospective studies with a structured protocol must be conducted to further investigate the effects of [low-intensity] focused ultrasound] on cancer-related neuropathic pain and to determine which treatment parameters and protocols are most beneficial.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Patel AA, Zhukosvky M, Sidharthan S, Jotwani R, Rakesh N, Gulati A. Preliminary effects of low-intensity focused ultrasound treatment program for cancer-related neuropathic pain. Pain Manag. Published online June 9, 2021. doi:10.2217/pmt-2020-0099

This article originally appeared on Clinical Pain Advisor