QLTI-10. COST-EFFECTIVENESS OF SCRAMBLER THERAPY (CALMARE®) FOR THE TREATMENT OF CHRONIC CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY

• Published in: Neuro-oncology (Charlottesville, Va.) Vol. 24; no. Supplement_7; p. vii236
• Main Author: Prakash, Neal
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 14-11-2022
• Subjects: Quality Improvement
• ISSN: 1522-8517; 1523-5866
• DOI: 10.1093/neuonc/noac209.912

Abstract
BACKGROUND
Acute chemotherapy-induced peripheral neuropathy (CIPN) is a common and serious consequence of cancer treatment. However, for up to 30% of patients, CIPN persists beyond six months of completing chemotherapy, and is transformed to chronic (c)CIPN. Scrambler therapy (ST) is a therapeutic modality with emerging evidence supporting its ability to diminish CIPN symptoms, however, low reimbursement limits patient access to this potentially curative therapy.
METHODS
Data was from a convenience sample of 24 CIPN patients (with symptoms between 1-240 months after platinum-based, taxane, or combination chemotherapy) completing 10 sessions of ST using the Calmare® device in the City of Hope Outpatient Physical Therapy Department. Patients were treated for ~45 minutes per session over 10 sessions. Patients received a standardized assessment pre- and post ST that included: EORTC chemotherapy-induced peripheral neuropathy questionnaire (QLQ-CIPN20), mono-filament testing, pain intensity numerical rating scale, numbness scale, extensor hallicus longus strength, Timed Up and Go, Romberg, and single leg balance.
RESULTS
Significant changes were seen in post-treatment assessment of quality of life as measured by the QLQ-CIPN-20 and numbness scale. Post-treatment QLQ-CIPN-20 total scores decreased by an average of 7.1 points (n= 24, p< .01). Numbness in the left lower extremity decreased by an average of 1 point of the 0-4 point scale (n=24, p=.0007) and 1.09 points on the right lower extremity (n=24, p < .0004). There was a trend towards improvements in pain, monofilament testing, single leg balance, and Romberg test. Reimbursement for ST did not cover the costs to administer the therapy.
CONCLUSION
For patients with CIPN, scrambler therapy improves numbness and improves quality of life measures. However, reimbursement for ST did not cover the costs. Ways to improve this disparity are discussed.