Preliminary Effects of Low-Intensity Focused Ultrasound Treatment Program for Cancer-Related Neuropathic Pain

Abstract

Aim: To evaluate the effectiveness of low-intensity focused ultrasound (LIFU) therapy in the management of cancer-related neuropathic pain (CNP). Methods: A retrospective review with 22 patients with CNP treated with LIFU therapy (frequency 3 Hz, 3 W/cm², pulse mode duty cycle 50%) was conducted. Results: Out of the 22 patients, 15 had CNP secondary to chemotherapy-induced peripheral neuropathy. Compared with baseline, there was a significant reduction in numeric pain rating scale (p < 0.001). Additionally, 76.5% of patients (n = 13) were considered to be responders to LIFU therapy. Conclusion: LIFU therapy may be a viable treatment modality in the management of CNP, specifically chemotherapy-induced peripheral neuropathy, with a minimal side effect profile. Larger, prospective studies with a structured protocol are necessary.

Lay abstract

With recent advancements in oncological treatments, there has been an increase in the number of cancer survivors. This has led to an increase in prevalence and burden of long-term side effects of oncological disease and associated treatments. Cancer-related neuropathic pain (CNP) is a debilitating pain condition that develops in the setting of direct tumor burden or as a result of cancer-related treatments, such as chemotherapy. Management can be challenging and clinicians are often limited to pharmacological agents and more invasive modalities. This study evaluated the effectiveness of low-intensity focused ultrasound (LIFU), a noninvasive, externally applied therapeutic ultrasound device, as a treatment for CNP. Twenty-two patients with CNP were treated with LIFU and found to have significant reduction in pain, suggesting LIFU may be an effective treatment modality in the management of CNP. This pilot study has laid the ground work for future prospective studies to further investigate the effects of LIFU on CNP.

Keywords::

• cancer-related pain
• chemotherapy-induced peripheral neuropathy
• low-intensity focused ultrasound
• malignancy
• neuropathic pain
• therapeutic ultrasound

Financial & competing interests disclosure

A Gulati is a consultant for Medtronic as well as a scientific advisor for Medtronic, Flowonix, Advanced Infusion Solutions, SPR Therapeutics, Nalu Medical and Bausch Health. This study was supported by the Memorial Sloan-Kettering Cancer Center Support Grant (NIH Core Grant Number P30 CA008748) and the Department of Anesthesiology and Critical Care. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Additional information

Funding

A Gulati is a consultant for Medtronic as well as a scientific advisor for Medtronic, Flowonix, Advanced Infusion Solutions, SPR Therapeutics, Nalu Medical and Bausch Health. This study was supported by the Memorial Sloan-Kettering Cancer Center Support Grant (NIH Core Grant Number P30 CA008748) and the Department of Anesthesiology and Critical Care. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.