Preventive and Therapeutic Efficacy of Thalidomide in Paclitaxel-Induced Peripheral

Abstract Purpose: The main adverse effects of paclitaxel chemotherapy are arthralgia, myalgia, and neuropathic pain. The objective of this research was to assess the potential preventive benefits, continuous management strategies, and the likelihood of remission and recurrence of these symptoms after Thalidomide treatment. Methods: This retrospective study reviewed the medical histories of 120 cancer patients who experienced arthralgia, myalgia, and neuropathic pain while undergoing paclitaxel chemotherapy at The First People’s Hospital of Yulin, Guangxi, from March 2022 to December 2023. The patients were stratified into two groups according to whether they received Thalidomide or not: with Thalidomide (n = 48) or without Thalidomide (n = 34). Pain assessments were initiated at the first sign of symptoms during the initial treatment cycle and were repeated over the next three cycles to assess the effectiveness of Thalidomide in managing symptoms and its preventive capabilities. The assessments employed the Common Terminology Criteria for Adverse Events (CTCAE) and the painDETECT questionnaire to measure the intensity of pain experienced by the patients. Findings: At the study’s inception, the neuropathic pain score was 21.17±2.69 for the Thalidomide group and 20.24±2.47 for the non-Thalidomide group. Subsequent follow-ups revealed a dramatic reduction to 0.13±0.44 in the Thalidomide group and to 6.68±1.90 in the non-Thalidomide group.. Neuropathic pain, along with arthralgia and myalgia, was more pronounced at baseline and in the third treatment cycle. A significant difference was noted between the two groups (all p<0.05). Implications: The findings of this research indicate that Thalidomide is effective in alleviating neuropathic paindue to paclitaxel. The preemptive application of Thalidomide proved to be exceptionally potent in providing rapid pain relief. Subsequent monitoring revealed that Thalidomide sustained its efficacy across multiple treatment cycles.