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Clinical Research Article

Korean J Pain 2021; 34(4): 427-436

Published online October 1, 2021 https://doi.org/10.3344/kjp.2021.34.4.427

Copyright © The Korean Pain Society.

Usefulness of cyclic thermal therapy and red blood cell scintigraphy in patients with chemotherapy-induced peripheral neuropathy

Minjoo Kim1 , Eun-Mi Kim1 , Phil-Sun Oh1 , Seok Tae Lim1 , Myung-Hee Sohn1 , Eun-Kee Song2 , Keon Uk Park3 , Jin Young Kim3 , Kyoung Sook Won4 , Hwan-Jeong Jeong1

1Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Research Institute of Clinical Medicine, Biomedical Research Institute, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
2Division of Medical Oncology & Hematology, Department of Internal Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
3Department of Hematology/Oncology, Keimyung University Dongsan Hospital, Daegu, Korea
4Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Daegu, Korea

Correspondence to:Hwan-Jeong Jeong
Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Research Institute of Clinical Medicine, Biomedical Research Institute, Jeonbuk National University Medical School and Hospital, 20, Geonji-ro, Jeonju 54907, Korea
Tel: +82-63-250-1674
Fax: +82-63-255-1172
E-mail: jayjeong@jbnu.ac.kr

Handling Editor: Jae Hun Kim

Received: March 5, 2021; Revised: June 1, 2021; Accepted: June 7, 2021

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Pharmacological and non-pharmacological therapies have been used to treat patients with chemotherapy-induced peripheral neuropathy (CIPN). However, the effect of therapies in cancer patients has yet to be investigated comprehensively. We hypothesized that cyclic thermal therapy would improve blood flow and microcirculation and improve the symptoms driven by CIPN.
Methods: The criteria of assessment were blood volume in region of interest (ROI) in the images, and European Organization for Research and Treatment of Cancer–Quality of Life Questionnaire–Chemotherapy-Induced Peripheral Neuropathy 20 questionnaire scores. The blood volume was quantified by using red blood cell (RBC) scintigraphy. All patients were treated 10 times during 10 days. The thermal stimulations, between 15° and 41°, were repeatedly delivered to the patient’s hands.
Results: The total score of the questionnaires, the score of questions related to the upper limbs, the score of questions closely related to the upper limbs, and the score excluding the upper limbs questions was decreased. The blood volume was decreased, and the variance of blood volume was decreased. During cooling stimulation, the blood volume was decreased, and its variance was decreased. During warming stimulation, the blood volume was decreased, and its variance was decreased.
Conclusions: We suggest that cyclic thermal therapy is useful to alleviate CIPN symptoms by blood circulation improvement. RBC scintigraphy can provide the quantitative information on blood volume under certain conditions such as stress, as well as rest, in peripheral tissue.

Keywords: Antineoplastic Agents, Blood Volume, Drug-Related Side Effects and Adverse Reactions, Drug Therapy, Microcirculation, Neuralgia, Peripheral Nervous System Diseases, Polyneuropathies, Radionuclide Imaging, Scintigraphy, Small Fiber Neuropathy.