THE ASSESSMENT OF THE EFFICIENCY OF ALPHA-LIPOIC ACID AND IPIDACRINE HYDROCHLORIDE TREATMENT IN THE PREVENTION OF PACLITAXEL-INDUCED PERIPHERAL NEUROPATHY BASED ON THE PATIENT NEUROTOXICITY QUESTIONNAIRE
Aim: to evaluate the efficiency of the combination of alpha-lipoic acid and acetylcholinesterase inhibitor ipidacrine hydrochloride in the prevention of the development of paclitaxel-induced peripheral neuropathy and improvment of its course in breast cancer patients using the data of the Patient Neurotoxicity Questionnaire. Object and Methods: 70 patients with breast cancer (T1–4N0–3M0–1) who underwent chemotherapy with the AT regimen (paclitaxel, doxorubicin) or ET regimen (paclitaxel, epirubicin) in neoadjuvant, adjuvant or palliative mode were randomized into two groups. The first group (n = 35) received the chemotherapy alone while the second group (n = 35) received the chemotherapy plus the treatment for prevention of neuropathy (alpha-lipoic acid in combination with ipidacrine hydrochloride). The patients completed the Patient Neurotoxicity Questionnaire before the chemotherapy and after the 3rd and the 6th cycles of paclitaxel polychemotherapy. Results: the paclitaxel-based polychemotherapy braught about sensory and motor peripheral neuropathy of the upper and/or lower extremities in the patients which progressed with increasing cumulative dose. Sensory peripheral neuropathy at higher severity levels affected the normal daily activities of the patients. First of all, those daily activities that require fine motor skills were disrupted in the patients with paclitaxel-induced peripheral neuropathy. Comparing the study groups, statistically significant improvements, according to the responses, were found in patients’ group II (who recived studied scheme of prevention of paclitaxel-induced peripheral neuropathy) as to the symptoms of sensory peripheral neuropathy, both after 3 and after 6 cycles of paclitaxel chemotherapy. In particular, in group II, in contrast to group I, neurosensory symptoms significantly improved by 18.95% (p<0.05) and 31.42% (p<0.01) respectively after 3 and 6 cycles of the chemotherapy with paclitaxel. However, there was not observed a statistically significant improvement in motor peripheral neuropathy symptoms in group II patients both after 3 and after 6 cycles of chemotherapy. Conclusion: the use of alpha-lipoic acid in combination with acetylcholinesterase inhibitor ipidacrine hydrochloride improves the course of paclitaxel-induced sensory peripheral neuropathy.