PREVENTION OF PACLITAXEL-INDUCED MOTOR NEUROPATHY OF FIBULAR AND TIBIAL NERVES WITH ALPHA-LIPOIC ACID AND IPIDACRIN HYDROCHLORIDE IN BREAST CANCER PATIENTS
DOI:
https://doi.org/10.15407/exp-oncology.2025.02.230Keywords:
paclitaxel, chemotherapy, motor neuropathy, electroneuromyography, alpha-lipoic acid, ipidacrine hydrochlorideAbstract
Aim. To investigate neurofunctional parameters of motor nerves in breast cancer (BCa) patients with paclitaxelinduced peripheral neuropathy (PIPN) and to determine the feasibility of using alpha-lipoic acid (ALA) in combination with ipidacrine hydrochloride (IPD) for PIPN prevention. Materials and Methods. The study included 100 patients with BCa stages II—IV, who were treated with polychemotherapy (PCT) according to the AT (paclitaxel, doxorubicin) or ET (paclitaxel, epirubicin) scheme in the neoadjuvant, adjuvant, or palliative regimens. Patients were randomized into two groups (n = 50 in each): group I received PCT only; group II – PCT in combination with ALA + IPD. Electroneuromyographic (ENMG) studies of the motor fibular and tibial nerves were performed before the start of chemotherapy and after the 3rd and 6th cycles of PCT. Results. Comparison of ENMG parameters of the motor nerves of the lower extremities of BCa patients before the start of PCT with these parameters after 3 and 6 PCT cycles indicated a slightly pronounced but significant decrease in the M-response and partly the nerve conduction velocity, which progressed with an increase in the cumulative dose of paclitaxel. Despite this, the average values of ENMG parameters remained within normal limits even after 6 cycles of PCT. The detected changes indicated a tendency toward axonal damage and mild myelinopathy. Significantly higher M-response rates of motor nerves were found in patients of group II compared to group I only after 6 cycles of PCT with paclitaxel. Conclusion. The use of ALA and IPD improves the functional state of the axons in patients with BCa treated with paclitaxel.
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