Chemotherapy-induced peripheral neuropathy (CIPN), a common side effect of chemotherapy, needs better effective treatments. Preliminary data support the use of Scrambler therapy, a device which treats pain via noninvasive cutaneous electrostimulation, for the treatment of CIPN. The current manuscript reports data from a pilot trial, performed to investigate the effect of Scrambler therapy for the treatment of established CIPN.
Eligible patients had CIPN symptoms of ≥1 month duration with tingling and/or pain ≥4/10 during the prior week. Patients were treated with Scrambler therapy to the affected area(s) for up to ten daily 30-min sessions. Symptoms were monitored using a neuropathy questionnaire consisting of numerical analog scales ranging from 0 to 10, daily before therapy as well as weekly for 10 weeks after therapy. Descriptive summary statistics formed the basis of data analysis.
Thirty-seven patients were enrolled. Twenty-five patients were treated primarily on their lower extremities while 12 were treated primarily on their upper extremities. There was a 53 % reduction in pain score from baseline to day 10; a 44 % reduction in tingling; and a 37 % reduction in numbness. Benefit appeared to last throughout 10 weeks of follow-up. There were no substantial adverse events.
Preliminary data support that Scrambler therapy may be effective for the treatment of CIPN: a prospective placebo-controlled clinical trial should be performed.
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Barton DL, Wos EJ, Qin R, Mattar BI, Green NB, Lanier KS, Bearden JD 3rd, Kugler JW, Hoff KL, Reddy PS, Rowland KM Jr, Riepl M, Christensen B, Loprinzi CL (2011) A double-blind, placebo-controlled trial of a topical treatment for chemotherapy-induced peripheral neuropathy: NCCTG trial N06CA. Support Care Cancer 19:833–841
Campbell TC, Nimunkar AJ, Retseck J, Eickhoff JC, Backonja M, Cleary JF, Kwekkeboom KL, Yen TY (2013) A randomized, double-blind study of "Scrambler" therapy versus sham for painful chemotherapy-induced peripheral neuropathy (CIPN). J Clin Oncol 31: suppl; abstr 9635
Coyne PJ, Wan W, Dodson P, Swainey C, Smith TJ (2013) A trial of scrambler therapy in the treatment of cancer pain syndromes and chronic chemotherapy-induced peripheral neuropathy. J Pain Palliat Care Pharmacother 27:359–364
de Boer AG, van Lanschot JJ, Stalmeier PF, van Sandick JW, Hulscher JB, de Haes JC, Sprangers MA (2004) Is a single-item visual analogue scale as valid, reliable and responsive as multi-item scales in measuring quality of life? Qual Life Res 13:311–320
Durand JP, Deplanque G, Montheil V, Gornet JM, Scotte F, Mir O, Cessot A, Coriat R, Raymond E, Mitry E, Herait P, Yataghene Y, Goldwasser F (2011) Efficacy of venlafaxine for the prevention and relief of oxaliplatin-induced acute neurotoxicity: results of EFFOX, a randomized, double-blind, placebo-controlled phase III trial. Ann Oncol 1:200–5
Eurich DT, Johnson JA, Reid KJ, Spertus JA (2006) Assessing responsiveness of generic and specific health related quality of life measures in heart failure. Health Qual Life Outcomes 4:89
Fitzpatrick R, Ziebland S, Jenkinson C, Mowat A (1993) Transition questions to assess outcomes in rheumatoid arthritis. Br J Rheumatol 32:807–811
Hammack JE, Michalak JC, Loprinzi CL, Sloan JA, Novotny PJ, Soori GS, Tirona MT, Rowland KM Jr, Stella PJ, Johnson JA (2002) Phase III evaluation of nortriptyline for alleviation of symptoms of cis-platinum-induced peripheral neuropathy. Pain 98:195–203
Hauser K, Walsh D (2008) Visual analogue scales and assessment of quality of life in cancer. J Support Oncol 6:277–282
Kastenbauer T, Sauseng S, Brath H, Abrahamian H, Irsigler K (2004) The value of the Rydel-Seiffer tuning fork as a predictor of diabetic polyneuropathy compared with a neurothesiometer. Diabetic Med: J B Diabetic Assoc 21:563–567
Kautio AL, Haanpaa M, Saarto T, Kalso E (2008) Amitriptyline in the treatment of chemotherapy-induced neuropathic symptoms. J Pain Symptom Manag 35:31–39
Locke DE, Decker PA, Sloan JA, Brown PD, Malec JF, Clark MM, Rummans TA, Ballman KV, Schaefer PL, Buckner JC (2007) Validation of single-item linear analog scale assessment of quality of life in neuro-oncology patients. J Pain Symptom Manag 34:628–638
Marineo G (2003) Untreatable pain resulting from abdominal cancer: new hope from biophysics? JOP 4:1–10
Marineo G, Iorno V, Gandini C, Moschini V, Smith TJ (2011) Scrambler therapy may relieve chronic neuropathic pain more effectively than guideline-based drug management: results of a pilot, randomized. Controll Trial J Pain Symptom Manag 43(1):87–95
Rao RD, Flynn PJ, Sloan JA, Wong GY, Novotny P, Johnson DB, Gross HM, Renno SI, Nashawaty M, Loprinzi CL (2008) Efficacy of lamotrigine in the management of chemotherapy-induced peripheral neuropathy: a phase 3 randomized, double-blind, placebo-controlled trial, N01C3. Cancer 112:2802–2808
Rao RD, Michalak JC, Sloan JA, Loprinzi CL, Soori GS, Nikcevich DA, Warner DO, Novotny P, Kutteh LA, Wong GY (2007) Efficacy of gabapentin in the management of chemotherapy-induced peripheral neuropathy: a phase 3 randomized, double-blind, placebo-controlled, crossover trial (N00C3). Cancer 110:2110–2118
Ricci M, Pirotti S, Scarpi E, Burgio M, Maltoni M, Sansoni E, Amadori D (2011) Managing chronic pain: results from an open-label study using MC5-A Calmare(R) device Support Care Cancer. (2):405–12
Sabato AF, Marineo G, Gatti A (2005) Scrambler therapy. Minerva Anestesiol 71:479–482
Saif MW, Syrigos K, Kaley K, Isufi I (2010) Role of pregabalin in treatment of oxaliplatin-induced sensory neuropathy. Anticancer Res 30:2927–2933
Smith EM, Pang H, Cirrincione C, Fleishman S, Paskett ED, Ahles T, Bressler LR, Fadul CE, Knox C, Le-Lindqwister N, Gilman PB, Shapiro CL (2013) Effect of duloxetine on pain, function, and quality of life among patients with chemotherapy-induced painful peripheral neuropathy: a randomized clinical trial Jama 309: 1359–1367
Smith TJ, Coyne PJ, Parker GL, Dodson P, Ramakrishnan V (2010) Pilot trial of a patient-specific cutaneous electrostimulation device (MC5-A Calmare(R)) for chemotherapy-induced peripheral neuropathy. J Pain Symptom Manag 40:883–891
Sparadeo F, Kaufman C, D'Amato S (2012) Scrambler therapy: an innovative and effective treatment for chronic neuropathic pain. J Life Care Plan 11:3–15
Whitton TL, Johnson RW, Lovell AT (2005) Use of the Rydel-Seiffer graduated tuning fork in the assessment of vibration threshold in postherpetic neuralgia patients and healthy controls. Eur J Pain 9:167–171
Windebank AJ, Grisold W (2008) Chemotherapy-induced neuropathy. J Peripher Nerv Syst 13:27–46
Wolf SL, Barton DL, Qin R, Wos EJ, Sloan JA, Liu H, Aaronson NK, Satele DV, Mattar BI, Green NB, Loprinzi CL (2011) The relationship between numbness, tingling, and shooting/burning pain in patients with chemotherapy-induced peripheral neuropathy (CIPN) as measured by the EORTC QLQ-CIPN20 instrument, N06CA. Support Care Cancer 20(3):625–32
Conflict of interest
Competitive Technologies provided the Scrambler machine and supplies for conduct of this trial but had no input into the writing of this manuscript. We have control of the primary data, which is available to the Journal to review, if indicated.
This study was supported by the US National Institutes of Health (grant CA 124477) and also by Mayo CTSA (grant no. UL1 TR000135).
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Pachman, D.R., Weisbrod, B.L., Seisler, D.K. et al. Pilot evaluation of Scrambler therapy for the treatment of chemotherapy-induced peripheral neuropathy. Support Care Cancer 23, 943–951 (2015). https://doi.org/10.1007/s00520-014-2424-8
- Scrambler therapy
- Chemotherapy-induced peripheral neuropathy