Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

TMaC Study: A patient-blinded, randomised, sham-controlled, parallel-group study evaluating effects of repetitive Transcranial Magnetic stimulation on Chemotherapy-induced pain in bowel cancer patients (125752)

Eva Moore 1 , Cassandra Gordon 1 , Brad Gauvin 2 , Timothy Price 1 3 , Mark Slee 4 , Hannah Wardill 1 , Simranjit Kaur Sidhu 1 , Joanne Bowen 1
  1. School of Biomedicine , The University of Adelaide, Adelaide, South Australia , Australia
  2. N/A, Patient partner, No academic affiliation
  3. The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia , Australia
  4. College of Medicine and Public Health, Flinders University, Adelaide, South Australia , Australia

Objectives:

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and debilitating complication characterised by persistent pain and dysaesthesia, significantly affecting survivors’ quality of life. Despite its impact, effective treatments for CIPN-associated sensory disturbances remain limited. Transcranial magnetic stimulation (TMS), a non-invasive brain modulation technique, shows emerging promise for neuropathic pain management. Therefore, this study aims to determine the analgesic and sensory-modulating potential of TMS in chronic CIPN.

Sample and setting:

This is an investigator-led phase II RCT conducted in an academic setting, enrolling bowel cancer survivors previously treated with oxaliplatin-containing chemotherapy.

Procedures: 

Participants are randomised (1:1) to receive TMS or sham stimulation over four weekly sessions. Pain (primary outcome) and dysaesthesia are assessed immediately before and after each session using the Visual Analogue Scale.

Results:

Since recruitment commenced in February 2025, 11 participants (28% of target) have completed all treatment sessions with 100% retention, supporting feasibility of treatment regimen. Preliminary data show reductions in pain (100% in TMS vs. 29% in sham) and dysaesthesia (54% TMS vs. 51% sham) from baseline to treatment completion. Hospital Anxiety and Depression Scale scores improved in both groups (33% TMS vs. 56% sham), suggesting potential psychological benefits and reinforcing the value of placebo control.

Conclusion and clinical implications:

Recruitment is projected to reach 65% by November, with additional outcome data available for presentation. Seasonal cold hypersensitivity is frequently reported and may confound sensory symptom perception; this should be accounted for in result interpretation and considered in future protocols. Qualitative feedback highlights limitations of the sensory CIPN questionnaire in reflecting lived sensory experiences, underscoring the need to refine patient-reported measures to ensure meaningful and accurate symptom representation of chronic CIPN. TMS may offer a viable, non-pharmacological intervention for relieving CIPN-associated sensory disturbances and supporting psychological wellbeing, with the potential for clinical integration into long-term survivorship care.