ASSESSMENT OF EFFICIENCY OF ALPHA-LIPOIC ACID AND IPIDACRINE HYDROCHLORIDE TREATMENT FOR PREVENTION OF PACLITAXEL-INDUCED PERIPHERAL NEUROPATHY USING THE EQ-5D 5L QUALITY OF LIFE QUESTIONNAIRE

Introduction. Paclitaxel is the most common chemotherapeutic agent fromthe taxane family, which is effective in treating many cancer types, including breast cancer. Despite the benefits of taxane-containing treatment regimens, patients develop neurosensory and neuromotor symptoms associated with the treatment, a condition known as chemotherapy-induced peripheral neuropathy.The aim of the study. To evaluate the efficacy of a combination of alpha-lipoic acid and acetylcholinesterase inhibitor ipidacrine hydrochloride to prevent the development of paclitaxel-induced peripheral neuropathy and improveits course in patients with breast cancer using the data ofthe EQ-5D 5LQuality of Life Questionnaire.Materials and methods.The study was conducted on 70 patients with breast cancer (T1-4N0-3M0-1),who were hospitalized at the Precarpathian Clinical Oncology Center of Ivano-Frankivsk Regional Council in 2014-2022. All patients received six cycles of chemotherapy according to the AT or ET regimens: paclitaxel at a dose of 175 mg/m2asa 3-hour infusion + doxorubicin 60 mg/m2(AT), or paclitaxel at a similar dose + epirubicin 90 mg/m2(ET) oncein 3 weeks in neoadjuvant, adjuvant or palliative modes. Patients were randomized into two groups: patients of group I (n = 35) received polychemotherapy without the use of drugs for the prevention of neuropathy,and patientsof group II (n = 35) received polychemotherapy and apreventive treatmentof neuropathy. The scheme for the prevention of paclitaxel-induced peripheral neuropathy included a combination of alpha-lipoic acid with an acetylcholinesterase inhibitor ipidacrine hydrochloride.In order to assess the quality of life and effectiveness of the studied paclitaxel-induced peripheral neuropathy prevention regimen in patients with breast cancer, we have usedthe EQ-5D 5L quality of life questionnaire beforeandafter the 3rd and 6th cycles of paclitaxel chemotherapy.Results.Thestudy of breast cancer patients showed a statistically significant deterioration in all five aspects of quality of life included in the EQ-5D 5L quality of life questionnaire, which progressed with increasing cumulative dose of paclitaxel. In addition, the application of the study scheme for the prevention of paclitaxel-induced peripheral neuropathy in patients of group II, in contrast to patients of group I, led to a statistically significant improvement according to theiranswers to questions about pain or discomfort, both after 3 and after 6 cycles of chemotherapy with paclitaxel -by 14.09% (p <0.05) and 19.49% (p <0.01), respectively. Accordingtothequestionnaire data, after 6 cycles of chemotherapy self-care ofpatients of group II in contrast to patients of group I significantly improved (by 21.21%, p < 0.05).Patients' answers to questions about the other three aspects of quality of life (mobility, normal daily activities, anxiety or depression) did not show a significant improvement in patients ofgroup II, both after 3 and 6 cycles of paclitaxel chemotherapy. The mean value of the assessment of the general condition according to the visual-analog scale significantly improved after 3 and 6 cycles of chemotherapy with paclitaxel inpatients ofgroup II, in contrast to patients of group I-by 6.80%(p <0.001) and 13.40% (p <0.001), respectively.