American Society of Clinical Oncology Clinical Practice Guidelines
What You Need to Know: Although the chemotherapy–induced peripheral neuropathies (CIPN) trials are inconclusive regarding tricyclic antidepressants (such as nortriptyline), gabapentin, and a compounded topical gel containing baclofen, amitriptyline HCL, and ketamine, these agents may be offered on the basis of data supporting their utility in other neuropathic pain conditions given the limited other CIPN treatment options.
The Study: A systematic literature search identified relevant, randomized controlled trials (RCTs) for the treatment of CIPN. Primary outcomes included incidence and severity of neuropathy as measured by neurophysiologic changes, patient-reported outcomes, and quality of life.
- A total of 48 RCTs met eligibility criteria and comprise the evidentiary basis for the recommendations.
- Trials tended to be small and heterogeneous, many with insufficient sample sizes to detect clinically important differences in outcomes.
- Primary outcomes varied across the trials, and in most cases, studies were not directly comparable because of different outcomes, measurements, and instruments used at different time points.
- The strength of the recommendations is based on the quality, amount, and consistency of the evidence and the balance between benefits and harms.
I’m Dr. Michael Hunter.
The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.
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Reference: Journal of Clinical Oncology, 18 April 2014