Light Therapy for Chemotherapy Induced Peripheral Neuropathy in Childhood Cancer Survivors

This prospective single-arm pilot study will assess the feasibility of a 6-week at-home light therapy intervention for CIPN. Survivors of childhood cancer (<21 years at diagnosis), ages five years or older at the time of survivorship clinic visit, with a history of exposure to vinca alkaloid, platinum, or other chemotherapeutic agent that can cause CIPN, will be included if they have CIPN (defined as a score of four or higher on the pediatric modified Total Neuropathy Score for survivors <18 years old at evaluation, or the modified Total Neuropathy Score for survivors 18 years or older at evaluation). The primary outcome of the study will be feasibility of the at-home protocol, measured as proportion of survivors who complete at least 12 at-home light therapy sessions, with ≥70% of survivors completing 12 or more sessions indicating feasibility. Secondary outcomes include 1) Proportion of survivors satisfied with intervention, measured as a mean score of 3 or higher on a 4-point Likert-scale survey 2) Facilitators and barriers to implementation of light-therapy, assessed by semi-structured qualitative interviews with 5-10 survivors who adhered and did not adhere to the protocol, and 3) change in neuropathy symptoms (measured by change in modified Total Neuropathy Score or pediatric-modified Total Neuropathy Score, and gait speed) from baseline to 1 week post intervention.

Inclusion criteria

• History of childhood cancer (<21 years of age at diagnosis)
• Current age five years or older (due to availability of validated measures for CIPN in this age group)
• History of exposure to vinca alkaloid, platinum, or other chemotherapeutic agent that can cause CIPN
• CIPN as assessed by a trained physical therapist defined as a score of four or higher on the ped-mTNS (for survivors <18 years old at evaluation), or the mTNS (for survivors 18 years or older at evaluation)

Exclusion criteria

• Currently Pregnant or lactating (by patient report, at initiation or at any point of the study)
• Inability to sit still for at least 15 minutes
• Diagnosis of neuropathy prior to cancer treatment
• Active cancer diagnosis or cancerous skin lesion
• Central nervous system tumor (due to lack of validated measures for CIPN in this population)
• Cancer lesion or open wound in the area to be treated, or any condition that can potentially be made worse by the correct or incorrect use of the device.