Examining the effectiveness of combination therapy in alleviating peripheral neuropathy and sleep disorders in breast cancer patients receiving chemotherapy.

Abstract

Objective: Exploring the efficacy of compression therapy and combined therapies in alleviating chemotherapy-induced peripheral neuropathy and sleep disturbances in breast cancer patients.

Methods: A total of 120 breast cancer patients who developed chemotherapy-induced peripheral neuropathy (CIPN) after receiving chemotherapy at Tangshan People's Hospital were consecutively enrolled and randomly assigned into three groups. The control group received standard treatment, while the compression group received a three-level pressure compression therapy in addition to standard treatment. The combination group received a combined therapy (compression combined with exercise). Assessments were conducted using the National Cancer Institute-Common Toxicity Criteria (NCI-CTC version 4.0) and the Pittsburgh Sleep Quality Index (PSQI) before intervention, after four cycles of intervention, and at a 6-month follow-up. Comparisons were made among the three groups in terms of the incidence of CIPN and differences in PSQI scores.

Results: We proposed a novel "dual-target intervention" strategy: reducing chemotherapy drug retention (mechanical protection) through hand and foot compression (with a pressure of 30-48 mmHg) and promoting nerve repair (functional repair) through progressive EXCAP exercise (with a weekly step count increase of 5-20%). In the combination group, the proportion of patients with grade 1 CIPN was significantly higher than that in the compression group and the control group after four cycles of intervention (100.0 vs. 75.0 vs. 50.0%, P < 0.001), while the proportion of patients with grade 2 CIPN was significantly lower than that in the compression group and the control group (0.0 vs. 25.0 vs. 50.0%, P < 0.001). Moreover, this effect persisted until the 6-month follow-up (grade 0 72.2 vs. 44.4 vs. 19.4%, P < 0.001; grade 1 27.8 vs. 38.9 vs. 41.7%, P < 0.001; grade 2 0.0 vs. 16.7 vs. 38.9%, P < 0.001). The reduction in total PSQI score was significantly greater in the combination group versus the control at the 4-cycle assessment (P < 0.001). A generalized estimating equation (GEE) confirmed significant effects of time, group, and their interaction (all P < 0.001). At the four-cycle intervention point and the 6-month follow-up, the total HADS scores in the combination group and the compression group were significantly lower than those in the control group, and the total HADS score in the combination group was lower than that in the compression group (P < 0.001).

Conclusion: Both intervention methods can effectively reduce the incidence of CIPN in breast cancer patients undergoing chemotherapy, improve their sleep quality, and alleviate negative emotions. Moreover, the combination group outperforms the compression group, and this mechanism may be related to multi-pathway regulation involving metabolism, nerve function, and psychological factors.