Background: Docetaxel (DTX)-induced nail and skin toxicity can be prevented by frozen glove. We investigate whether we can use cooling gel pad (CGP), which is available less than 10 dollars in Japan, as less expensive alternative.Method: Patients (pts) with breast cancer receiving DTX as preoperative or post operative chemotherapy were eligible for this study. Two CGPs, which were refrigerated for eight hours beforehand, were used to cover patient's hand from 15 minutes before to 15minutes after DTX administration. To reduce discomfort from icing, pts were wearing cotton glove during CGP usage. If pts felt CGP as too cold during the cooling process, they were allowed to remove CGP tentatively until they felt comfort. Another hand was not covered as the control. Nail and skin toxicity were assessed at each cycle by CTCAEver.3.0 and documented by photography. Fisher's exact probability test was used. Satisfaction and discomfort of CGP covering was assessed by pts using two item questionnaires. All patients gave written informed consent. The protocol was approved by institutional review board.Result: From October 2006 to September 2008, 50 pts were enrolled to this study. All the patients were female, and received DTX 75mg/m2 in every three weeks schedule for four cycles. Most of patients received DTX after anthracycline-containing regimen. Both nail (10% v 66%, p<0.0001) and skin (0% v 34%, p<0.0001) toxicity was reduced in CGP covered hands. Nail toxicity was grade (G) 0 in 90% v 34%, G1 in 10% v 42%, G2 in 0% v 22%, and G3 in 0% v 2%, for CGP covered and the control hand, respectively. Skin toxicity was G0 in 100% v 66%, G1 in 0% v 4%, G2 in 0% v 30% in CGP covered hand and the control hand, respectively. About the timing of toxicity occurrence, “after the first cycle” was most common, 13 pts (39%) in nail change and 7 pts (41%) in skin toxicity. In the questionnaires, 94% were satisfied with CGP covering.Discussion: The iced CGP cover method reduced the incidence and severity of nail and skin toxicity associated with DTX, even if patients wear cotton glove and remove CGP for a while, in case of excess coldness. This method has no adverse effect, and patients were satisfied with the effect. The iced CGP may be considered as a new, effective and less expensive method for prevention of nail and skin toxicity caused by DTX.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1114.