4.6 Article

Long-term improvement by ozone treatment in chronic pain secondary to chemotherapy-induced peripheral neuropathy: A preliminary report

Journal

FRONTIERS IN PHYSIOLOGY
Volume 13, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fphys.2022.935269

Keywords

antioxidants; cancer survivorship; cancer therapy-induced side effects; chemotherapy-induced peripheral neuropathy; neuropathic pain; oxidative stress; ozone therapy; pain

Categories

Funding

  1. Instituto de Salud Carlos III (Spanish Ministry of Science and Innovation, Madrid, Spain) [PI 19/00458]
  2. Instituto de Salud Carlos III (European Regional Development Fund-ERDF) [PI 19/00458]
  3. Fundacion DISA (Las Palmas, Spain) [016/2019]
  4. Fundacion Espanola del Dolor (Spanish Pain Foundation, Madrid, Spain) [BF1-19-13]

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This report demonstrates the potential of ozone treatment as a modulator of oxidative stress in chronic pain secondary to chemotherapy-induced peripheral neuropathy (CIPN), leading to clinically relevant and long-lasting improvement in pain symptoms.
Background: Pain secondary to chemotherapy-induced peripheral neuropathy (CIPN) can limit the administration of chemotherapy, cancer-treatment outcomes, and the quality of life of patients. Oxidative stress and inflammation are some of the key mechanisms involved in CIPN. Successful treatments for CIPN are limited. This report shows our preliminary experience using ozone treatment as a modulator of oxidative stress in chronic pain secondary to CIPN. Methods: Ozone treatment, by rectal insufflation, was administered in seven patients suffering from pain secondary to grade II or III CIPN. Pain was assessed by the visual analog scale (VAS). Results: All patients, except one, showed clinically relevant pain improvement. Median pain score according to the VAS was 7 (range: 5-8) before ozone treatment, 4 (range: 2-6) at the end of ozone treatment (p = 0.004), 5.5 (range: 1.8-6.3) 3 months after the end of ozone treatment (p = 0.008), and 6 (range: 2.6-6.6) 6 months after the end of ozone treatment (p = 0.008). The toxicity grade, according to the Common Terminology Criteria for Adverse Events (CTCAE v.5.0), improved in half of the patients. Conclusion: This report shows that most patients obtained clinically relevant and long-lasting improvement in chronic pain secondary to CIPN after treatment with ozone. These observed effects merit further research and support our ongoing randomized clinical trial (NCT04299893).

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