ASSESSMENT OF EFFICIENCY OF ALPHA-LIPOIC ACID AND IPIDACRINE HYDROCHLORIDE TREATMENT FOR PREVENTION OF PACLITAXEL-INDUCED PERIPHERAL NEUROPATHY USING THE EQ-5D 5L QUALITY OF LIFE QUESTIONNAIRE
Authors: Holotyuk I. S. , Holotyuk S. I. 
Published: October 2022

Introduction. Paclitaxel is the most common chemotherapeutic agent from the taxane family, which is effective in treating many cancer types, including breast cancer. Despite the benefits of taxane-containing treatment regimens, patients develop neurosensory and neuromotor symptoms associated with the treatment, a condition known as chemotherapy-induced peripheral neuropathy.

The aim of the study. To evaluate the efficacy of a combination of alpha-lipoic acid and acetylcholinesterase inhibitor ipidacrine hydrochloride to prevent the development of paclitaxel-induced peripheral neuropathy and improve its course in patients with breast cancer using the data of the EQ-5D 5L Quality of Life Questionnaire.

Materials and methods. The study was conducted on 70 patients with breast cancer (T1-4N0-3M0-1), who were hospitalized at the Precarpathian Clinical Oncology Center of Ivano-Frankivsk Regional Council in 2014-2022. All patients received six cycles of chemotherapy according to the AT or ET regimens: paclitaxel at a dose of 175 mg/m2 as a 3-hour infusion + doxorubicin 60 mg/m2 (AT), or paclitaxel at a similar dose + epirubicin 90 mg/m2 (ET) once in 3 weeks in neoadjuvant, adjuvant or palliative modes. Patients were randomized into two groups: patients of group I (n = 35) received polychemotherapy without the use of drugs for the prevention of neuropathy, and patients of group II (n = 35) received polychemotherapy and a preventive treatment of neuropathy. The scheme for the prevention of paclitaxel-induced peripheral neuropathy included a combination of alpha-lipoic acid with an acetylcholinesterase inhibitor ipidacrine hydrochloride. In order to assess the quality of life and effectiveness of the studied paclitaxel-induced peripheral neuropathy prevention regimen in patients with breast cancer, we have used the EQ-5D 5L quality of life questionnaire before and after the 3rd and 6th cycles of paclitaxel chemotherapy.

Results. The study of breast cancer patients showed a statistically significant deterioration in all five aspects of quality of life included in the EQ-5D 5L quality of life questionnaire, which progressed with increasing cumulative dose of paclitaxel. In addition, the application of the study scheme for the prevention of paclitaxel-induced peripheral neuropathy in patients of group II, in contrast to patients of group I, led to a statistically significant improvement according to their answers to questions about pain or discomfort, both after 3 and after 6 cycles of chemotherapy with paclitaxel - by  14.09 % (p < 0.05) and 19.49 % (p < 0.01), respectively. According to the questionnaire data, after 6 cycles of chemotherapy self-care of patients of group II in contrast to patients of group I significantly improved (by 21.21 %, p < 0.05). Patients' answers to questions about the other three aspects of quality of life (mobility, normal daily activities, anxiety or depression) did not show a significant improvement in patients of group II, both after 3 and 6 cycles of paclitaxel chemotherapy. The mean value of the assessment of the general condition according to the visual-analog scale significantly improved after 3 and 6 cycles of chemotherapy with paclitaxel in patients of group II, in contrast to patients of group I - by 6.80 % (p < 0.001) and 13.40 % (p < 0.001), respectively.