ASSESSMENT OF THE ROLE OF ALPHALIPOIC ACID IN PREVENTION OF CHEMOTHERAPY INDUCED PERIPHERAL NEUROPATHY

Introduction: Chemotherapy induced peripheral neuropathy (CIPN) is a common dose limiting side effect of many chemotherapeutic agents. It is considered the second most common acute side effect after hematologic toxicity .It affects ~ 30 % of patients receiving chemotherapy. Causes of CIPN in not exactly known and well understood. However treatments that are used to treat this condition have been found to be ineffective and have many undesirable side effects. Alpha Lipoic acid (ALA) is a physiological anti-oxidant that has been found effective in diabetic neuropathy, but hasn't been investigated thoroughly for the use in CIPN. Material and Methods: This is a prospective clinical trial conducted at Clinical Oncology Department in Suez Canal University Hospital, where one hundred patients received chemotherapy causing peripheral neuropathy were included in our study; they were divided into two equal groups, study and control group. Study group received ALA 6oo mg three times daily for 12 weeks from the start of chemotherapy, control group received no treatment. Assessment was done before starting treatment and after each cycle by using FACT/GOG-Ntx score. Results: A total of 100 patients were included in this study, 83% were females and 17% were males. 62% of patients had breast cancer and 17 % had GIT cancer.65% of patients received single neurotoxic agent causing peripheral neuropathy while 35% received combined agent causing peripheral neuropathy. 96% patients completed the study (12 weeks). There was a statistically significant difference between the ALA and the control groups for FACT/GOG-Ntx scores. Conclusions: CIPN is one of the most severe adverse effects of chemotherapy; with a significant impact on the Quality of life .This strategy of oral ALA administration was effective at preventing neurotoxicity.ALA as a neuroprotective agent has shown some promise.Future studies to explore ALA as a neuroprotective agent should take heed of the barriers confronted in this study.