Pachman, D.R., Weisbrod, B.L., Seisler, D.K., Barton, D.L., Fee-Schroeder, K.C., Smith, T.J., . . . Loprinzi, C.L. (2015). Pilot evaluation of Scrambler therapy for the treatment of chemotherapy-induced peripheral neuropathy. Supportive Care in Cancer, 23, 943–951. 

To determine the effectiveness of Scrambler therapy in patients with chemotherapy-induced peripheral neuropathy (CIPN)

Scrambler therapy involves the use of low-dose electrical stimulation delivered through electrodes placed around patient-reported painful areas. Five sets of electrodes can be placed around a painful area at one time. The goal of this study was to replace pain with no pain and/or lessening of symptoms. Patients were treated daily for up to 10 days.

• N = 37  
• AGE = 33–79 years
• MALES: 32%, FEMALES: 67%
• KEY DISEASE CHARACTERISTICS: Breast, ovarian, colon/rectal, lymphoma, and nine other primary cancers
• OTHER KEY SAMPLE CHARACTERISTICS: Thirteen patients were treated with taxol, eight received carboplatin/ taxol, nine received oxaliplatin, four received cisplatin therapies, and three received vincristine.

• SITE: Not stated/unknown    
• SETTING TYPE: Outpatient  
• LOCATION: USA

PHASE OF CARE: Mutliple phases of care

Prospective, open-label trial

Measurements included numerical analog scales from 0–10 that were part of a neuropathy questionnaire, a global impression of change questionnaire, and the Rydel-Seiffer Tuning Fork to evaluate patient vibratory sense.

Pain scores decreased 53% from baseline to day 10. Numbness decreased 37%, and tingling decreased 44%. Increased quality of life was reported during treatment as well as during the 10-week follow-up period. All of these changes were significant (p < 0.0002). The vibration perception scores measured with the Rydel-Seiffer Tuning Fork also improved.

Although Scrambler therapy demonstrated positive effects in this trial, a large randomized, controlled trial is needed to confirm its efficacy in CIPN. Special training and experienced personnel need to be in place for someone to deliver this therapy. Practicality and cost need to be factored in for this type of intervention.

• Small sample (< 100)
• Risk of bias (no control group)
• Risk of bias (no random assignment)
• Findings not generalizable
• Only 10 weeks of follow-up
• Thirty-two patients completed the study.
• Findings in solid tumors only and in a small number, making it hard to generalize findings

A large, randomized study is needed for future research. Scrambler therapy is not a very practical treatment, and cost of the treatment was not discussed. Also, specific training is needed to administer it. Currently, insufficient evidence recommends its use.