This study aims to show the efficacy and safety of ultra-sound guided peri-neural platelet rich injection in treatment of chemotherapy induced peripheral neuropathy.

This study is prospective, randomized, assessor blinded controlled trial. It is aims to study the effect of perineural platelet rich plasma injection in cancer patients with prepheral neuropathy despite of stoppage chemotherapy for 6 months and usage of medical treatment.

Ultrasound-guided PRP injection will be performed after preparation of plasma obtained from the patient by using 10-19 MHz high frequency linear transducer to scan the superficial nerves.

Inclusion Criteria:

• cancer patients with peripheral neuropathy confirmed by clinical evaluation and nerve conduction study despite of medical treatment

Exclusion Criteria: patients with:

• Foot ulcers and / or amputation.
• Peripheral vascular disease.
• Uncontrolled diabetes
• Vertebral pathologies.
• Connective tissue diseases.
• Thyriod disorders, significant renal or hepatic dysfunction.
• Platelet dysfunction syndrome, critical thrombocytopenia.
• Septicemia and local infection at the site of the procedure.
• Systemic corticosteriod adminstiration or local injection at the suspected treatment site within the last month.
• Recent fever or illness.
• Hemoglobin level less than 10 g/dl, platelet count less than 105-109/L.