Exercise Reduces Severity of Chemotherapy-Induced Peripheral Neuropathy

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CIPN  is common is those receiving taxane, platinum, or vinca-alkaloid–based chemotherapy, but exercise may help.
CIPN is common is those receiving taxane, platinum, or vinca-alkaloid–based chemotherapy, but exercise may help.

Patients with cancer who experience chemotherapy-induced peripheral neuropathy (CIPN) may experience improvement with exercise, according to a study published in Supportive Care in Cancer.

CIPN is a commonly occurring morbidity associated with cancer therapy; approximately 50% of patients who receive taxane, platinum, or vinca-alkaloid–based chemotherapy experience peripheral neuropathy, but effective therapeutic options are limited.


For this study, researchers evaluated the outcomes of 456 patients with cancer treated with CIPN-inducing chemotherapy regimens. Patients were randomly assigned to receive either chemotherapy or chemotherapy plus the Exercise for Cancer Patients (EXCAP) program, in which patients undergo moderate-intensity walking and resistance exercises for 6 weeks. All patients reported CIPN symptoms preintervention and postintervention.

Of the 456 patients enrolled, 355 completed both intervention assessments and were eligible for evaluation. Reasons for study drop-out included feeling overwhelmed, experienced some medical issue, or no reasons were given. Exercise-arm assignment, limited education, older age, and greater baseline fatigue were factors found to be significantly associated with study incompletion upon multivariate analysis.


After 6 weeks of chemotherapy, CIPN severity unexpectedly worsened compared with baseline reports, but to a lesser extent among patients assigned to the exercise arm. Analysis showed that the increases in CIPN symptoms of hot/coldness in hands/feet and numbness/tingling were lower by .46 units (P =.045) and 0.42 units (P =.076), respectively, among patients in the exercise arm compared with the control arm.

Patients who were older (P =.086), male (P =.028), and had breast cancer (P =.076) experienced greatest reduction of symptoms with exercise.  

The authors concluded that exercise “is a promising tool that clinicians should consider prescribing for patients receiving taxane-based, platinum-based, and vinca alkaloid-based drugs, especially for geriatric patients.

Reference

Kleckner IR, Kamen C, Gewandter JS, et al. Effects of exercise during chemotherapy on chemotherapy-induced peripheral neuropathy: a multicenter, randomized controlled trial [published online December 14, 2017]. Supp Care Cancer. doi: 10.1007/s00520-017-4013-0
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