Paclitaxel-induced Peripheral Neuropathy

The goal of this research is to assess whether hyperbaric oxygen therapy can alleviate the symptoms of Nab-paclitaxel-induced peripheral neuropathy and improve patient-reported quality of life.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common and often long-lasting side effect of cancer treatment. Patients may experience numbness, tingling, pain, burning sensations, weakness, or difficulty with walking and daily activities. Paclitaxel-related CIPN is especially common, and current treatment options are limited. For patients whose symptoms do not improve with standard therapies such as duloxetine, pregabalin, or gabapentin, there is an important unmet clinical need. Papaverine is a vasodilator and smooth muscle relaxant that may improve blood flow in the small vessels supplying nerves. Based on the hypothesis that impaired microcirculation and ischemia may contribute to CIPN, papaverine may help relieve symptoms and support nerve recovery. Preliminary clinical observations by the investigators suggested that papaverine injection may rapidly improve numbness and weakness in some patients with refractory paclitaxel-induced CIPN.This is a prospective, single-center, single-arm, open-label phase II study designed to evaluate the preliminary efficacy and safety of papaverine injection in patients with refractory paclitaxel-induced peripheral neuropathy. Eligible participants are adults aged 18 to 75 years with histologically or cytologically confirmed malignancy, prior treatment with a paclitaxel-containing regimen, persistent clinically significant neuropathy of grade 2 or higher, and failure of at least one standard treatment for CIPN. Participants will receive papaverine hydrochloride 120 mg diluted in 100 mL normal saline by intravenous infusion once daily, given as 1 treatment day followed by 6 rest days, with 7 days defined as one cycle. Up to 3 cycles of treatment may be given if patients benefit and tolerate therapy well.The main goal of the study is to assess improvement in patient-reported sensory neuropathy symptoms using the EORTC QLQ-CIPN20 sensory subscale. Secondary objectives include changes in overall neuropathy symptoms, physician-assessed neuropathy grade, quality of life, and safety. Exploratory assessments include nerve conduction findings and inflammatory biomarkers. The study aims to enroll approximately 43 patients and will provide early evidence on whether papaverine may be a useful treatment option for patients with refractory paclitaxel-induced CIPN.

This study aims to evaluate the effect of surgical glove compression as a prophylactic method to prevent paclitaxel-induced peripheral neuropathy. Participants will be randomly assigned to two groups: one receiving standard care, and the other receiving prophylactic surgical glove compression. The study will compare the development, severity of neuropathy in the hands and fingers, and its impact on quality of life.

This prospective, randomised, controlled study was designed to evaluate the effectiveness of salt and unsalted cold water foot baths in preventing chemotherapy-induced peripheral neuropathy (CIPN) in patients receiving paclitaxel. The study's sub-objectives were to minimise the development of CIPN, reduce its severity and incidence of symptoms, and minimise its impact on daily life and activities. Hypothesis(es): H1: Salt cold water foot bath affects the development of chemotherapy-induced peripheral neuropathy. H2: There is an effect of unsalted cold water foot bath on the development of chemotherapy-induced peripheral neuropathy. H3: The effects of salt and unsalted cold water foot baths on the development of chemotherapy-induced peripheral neuropathy. H4: Salt and unsalted cold water foot baths are more effective than standard clinical care in the development of chemotherapy-induced peripheral neuropathy. Researchers will compare the salt cold water with the unsalted cold water, unsalted cold water and control group to determine whether the salt cold water has an effect on CIPN. The experimental group and active comparator participants will continue the application for 12 cycles (12 weeks) of paclitaxel. The application will be applied by researcher Tuba Eryiğit. In addition, before each application for 12 weeks, the severity of CIPN, its effect on daily life and grade will be evaluated. The control group will continue clinical routine care applications for 12 cycles (12 weeks). In addition, the severity of CIPN, its effect on daily life and grade will be evaluated before each treatment in the same way as the experimental groups.

The aim of this randomized controlled trial (RCT) is to compare the incidence of paclitaxel-induced grade 2 or higher sensory peripheral neuropathy, evaluated using the CTCAE version 5.0, between patients receiving surgical glove-compression therapy (SGCT) and those in the control group. The main question is whether SGCT is effective in preventing paclitaxel-induced sensory peripheral neuropathy. * Intervention group: receive SGCT. * Control group: receive non-compressive plastic gloves.