Efficacy of Transcutaneous Electrical Acupoint Stimulation on Modulating Upper Extremity Sympathetic Skin Response in Alleviating Cancer Survivors With Chemotherapy-Induced Peripheral Neuropathy: A Propensity Score-Matched Cohort Study.

Objective:  Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy and it is currently intractable We compared the efficacy of transcutaneous electrical acupoint stimulation (TEAS) against non-TEAS groups and investigated the variables that predict effective relief of upper extremity pain in cancer survivors with CIPN.

Methods: We retrospectively collected data of cancer survivors who developed CIPN between May 2017 to March 2022. All eligible CIPN patients were divided into TEAS group (received TEAS) and non-TEAS group (did not receive TEAS) in our department. A 1:1 ratio propensity score matching (PSM) was used to balance the baseline features. The change of numerical rating scale (NRS), Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2), and sympathetic skin response (SSR) parameters are all assessed after treatment. The procedure was considered a clinically effective relief if the patients' NRS scores were reduced by 50% or more, and overall patients with effective relief were all counted after treatment. Furthermore, a multivariable logistic regression model was utilized to evaluate the predictors of effective relief following CIPN treatment.

Results : A total of 102 cancer survivors with CIPN were analyzed after PSM (51 in each group). The change of NRS, SF-MPQ-2, SSR latency and SSR amplitude in TEAS group were significantly higher than those in non-TEAS group at 3 weeks after therapy (all <0.01). In addition, the effective relief rate was significantly higher in TEAS group than in non-TEAS group (=0.026). Multivariate logistic regression on the total study cohort showed that TEAS group (OR 2.783, P = 0.025) and the baseline SSR amplitude of the upper extremity <1265 µV (OR 12.191, P = 0.000) were independent predictive factors for the clinical efficacy.

Conclusions : TEAS significantly decreased the severity of CIPN. TEAS group and baseline SSR amplitude of the upper extremity <1265 µV were the independent predictive factors for the clinical efficacy after treatment.