Low-Intensity Focused Ultrasound May Safely, Effectively Treat Chemo-Induced Peripheral Neuropathy

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.

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