A randomized pilot study of oncology massage to treat chemotherapy-induced peripheral neuropathy.
Study Goal
The researchers aimed to determine the ideal weekly frequency and duration of massage therapy for relieving chemotherapy-induced peripheral neuropathy (CIPN) symptoms and assess its feasibility and initial efficacy.
Results Summary
The study found that massage was feasible with high completion rates, and the more intensive regimen (3X/week for 4 weeks) showed statistically significant and clinically meaningful reductions in CIPN symptoms compared to the less intensive regimen (2X/week for 6 weeks). Targeting the affected area directly (lower extremities) with the intensive regimen yielded the best outcomes.
Population
Adults (mean age 60.3) with lower extremity CIPN attributed to oxaliplatin, paclitaxel, or docetaxel, at least 6 months post-chemotherapy, and self-reported neuropathy score ≥3 (0-10 scale).
Effective Dosage
2X/week for 6 weeks or 3X/week for 4 weeks.
Duration
4 weeks (3X/week) or 6 weeks (2X/week).
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Swedish massage protocol | no change | completion rates | patients with chemotherapy-induced peripheral neuropathy (CIPN) | mean completion rates (max = 12) were 8.9 (SD 4.2) for 3X/week and 9.8 (SD 4.0) for 2X/week | deemed feasible | #1 |
massage therapy | no change | Pain Quality Assessment Scale (PQAS) scores | patients with chemotherapy-induced peripheral neuropathy (CIPN) | no statistically significant differences | no statistically significant treatment group interactions | #2 |
massage therapy 3X/week for 4 weeks | decrease | PQAS subscales | patients with chemotherapy-induced peripheral neuropathy (CIPN) | p < 0.05 | statistically significant treatment schedule main effect | #3 |
massage therapy 3X/week for 4 weeks | decrease | CIPN symptoms | patients with chemotherapy-induced peripheral neuropathy (CIPN) | - | lower CIPN symptoms | #4 |
massage therapy 3X/week for 4 weeks | decrease | CIPN symptoms | patients with chemotherapy-induced peripheral neuropathy (CIPN) | - | improvements considered clinically significant | #5 |
massage therapy 3X/week for 4 weeks | decrease | CIPN symptom reduction | patients with chemotherapy-induced peripheral neuropathy (CIPN) | - | better outcomes | #6 |
massage program targeting the CIPN-affected area directly provided 3X a week for 4 weeks | decrease | CIPN symptoms | patients with chemotherapy-induced peripheral neuropathy (CIPN) | - | resulted in the best outcomes | #7 |
This pilot randomized controlled trial investigated massage therapy for symptomatic relief of chemotherapy-induced peripheral neuropathy (CIPN) to determine the ideal weekly frequency and number of weeks of providing massage. We evaluated the feasibility and initial efficacy of a Swedish massage protocol to treat lower extremity (LE) CIPN. Inclusion criteria: LE neuropathy attributed to oxaliplatin, paclitaxel, or docetaxel, with no other attributable causes; ≥ 6 months since last chemotherapy; self-reported neuropathy score ≥ 3, 0-10 scale; age ≥ 18. Participant randomization (2:2:1:1) to one of four groups: LE (2) or head/neck/shoulder (control; 1) massage 3 times (3X) a week for 4 weeks; LE (2) or control (1) massage 2X/week for 6 weeks. Completion rate and the Pain Quality Assessment Scale (PQAS) was measured at baseline and 10 weeks later. 71 patients participated: 77.5% women; 57.7% (breast cancer), and 42.3% (GI cancer); mean age 60.3 y/o (range: 40-77); average > 3 years since last chemotherapy. Massage was deemed feasible: mean completion rates (max = 12) were 8.9 (SD 4.2) for 3X/week and 9.8 (SD 4.0) for 2X/week with no statistically significant differences. There were no statistically significant treatment group interactions in PQAS scores at 10-weeks follow-up. There was a statistically significant treatment schedule main effect for PQAS subscales (p < 0.05) at 10 weeks, with lower CIPN symptoms for 3X/week groups versus 2X/week groups. Improvements considered clinically significant favored the LE 3X/week group. Completion rates met pre-defined feasibility criteria. We seemed to observe better outcomes (CIPN symptom reduction) with the more intensive (3X/week for 4 weeks) massage intervention with no differences in adherence, regardless of whether the massage was directly to the CIPN-affected area or not. However, there was some suggestion that the massage program targeting the CIPN-affected area directly provided 3X a week for 4 weeks resulted in the best outcomes.