The effectiveness of regional cooling for paclitaxel-induced peripheral neuropathy

Sato, Junya; Mori, Megumi; Nihei, Satoru; Kumagai, Miho; Takeuchi, Satoshi; Kashiwaba, Masahiro; Kudo, Kazuhiko

doi:10.1186/s40780-016-0067-2

Cited by 27 publications

(47 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies have employed frozen gloves as a mode of cryotherapy in preventing CIPN [4,8,9,14,23,29,31,32]. These studies have demonstrated frozen gloves are able to deliver considerable regional hypothermia, however, this effect is not sustained or stable thereby potentially reducing the efficacy of vasoconstriction.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent trial reported by Hanai et al (2018), cryotherapy in the form of frozen gloves was effective in preventing and reducing the occurrence of CIPN [9]. Similarly, inspired by scalp cooling therapy to combat chemotherapy-induced alopecia (CIA) [7,15], several groups have demonstrated promising results that the use of frozen gloves and socks concomitantly with the chemotherapy infusion is efficacious in reducing CIPN [4,9,23,29,31,32]. However, latest reports indicate that the frozen gloves have been recalled due to incidences of frostbite and other patient safety issues [10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Safety and tolerability of cryocompression as a method of enhanced limb hypothermia to reduce taxane-induced peripheral neuropathy

Bandla

Tan

Kumarakulasinghe

et al. 2019

Support Care Cancer

View full text Add to dashboard Cite

Purpose Severe peripheral neuropathy is a common dose-limiting toxicity of taxane chemotherapy, with no effective treatment. Frozen gloves have shown to reduce the severity of neuropathy in several studies but comes with the incidence of undesired side effects such as cold intolerance and frostbite in extreme cases. A device with thermoregulatory features which can safely deliver tolerable amounts of cooling while ensuring efficacy is required to overcome the deficiencies of frozen gloves. The role of continuous-flow cooling in prevention of neurotoxicity caused by paclitaxel has been previously described. This study hypothesized that cryocompression (addition of dynamic pressure to cooling) may allow for delivery of lower temperatures with similar tolerance and potentially improve efficacy. Method A proof-of-concept study was conducted in cancer patients receiving taxane chemotherapy. Each subject underwent four-limb cryocompression with each chemotherapy infusion (three hours) for a maximum of 12 cycles. Cryocompression was administered at 16°C and cyclic pressure (5-15 mmHg). Skin surface temperature and tolerance scores were recorded. Neuropathy was assessed using clinician-graded peripheral sensory neuropathy scores, total neuropathy score (TNS) and nerve conduction studies (NCS) conducted before (NCS pre), after completion (NCS post) and 3 months post-chemotherapy (NCS 3m). Results were retrospectively compared with patients who underwent paclitaxel chemotherapy along with continuous-flow cooling and controls with no hypothermia. Results In total, 13 patients underwent 142 cycles of cryocompression concomitant with chemotherapy. Limb hypothermia was well tolerated, and only 1 out of 13 patients required an intra-cycle temperature increase, with no early termination of cryocompression in any subject. Mean skin temperature reduction of 3.8 ± 1.7°C was achieved. Cryocompression demonstrated significantly greater skin temperature reductions compared to continuous-flow cooling and control (p < 0.0001). None of the patients experienced severe neuropathy (clinician-assessed neuropathy scores of grade 2 or higher). NCS analysis showed preservation of motor amplitudes at NCS 3m in subjects who underwent cryocompression, compared to the controls who showed Electronic supplementary material The online version of this article (

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety and tolerability of cryocompression as a method of enhanced limb hypothermia to reduce taxane-induced peripheral neuropathy

Bandla

Tan

Kumarakulasinghe

et al. 2019

Support Care Cancer

View full text Add to dashboard Cite

show abstract

“…The first evidence came as an explorative analysis, revealing that patients utilizing frozen gloves and socks for the prevention of docetaxel-induced nail toxicity experienced a 44% reduction in the risk of CIPN (13). Other studies have examined if similar benefits can be observed among patients receiving chemotherapy (14)(15)(16)(17)(18)(19)(20). However, the findings of these studies have been inconsistent, exemplifying the need for more confirmatory studies (21).…”

Section: Introductionmentioning

confidence: 99%

Impact of Cryotherapy on Sensory, Motor, and Autonomic Neuropathy in Breast Cancer Patients Receiving Paclitaxel: A Randomized, Controlled Trial

Tan

Soh

et al. 2020

Front. Neurol.

View full text Add to dashboard Cite

Introduction: We conducted a randomized controlled trial evaluating the efficacy and tolerability of cryotherapy in preventing chemotherapy-induced peripheral neuropathy (CIPN) in patients with early breast cancer receiving neo/adjuvant weekly paclitaxel.Methods: Patients were recruited from the National Cancer Centre Singapore and randomized (1:1) to receive either cryotherapy or usual care. Cryotherapy was applied as frozen gloves and socks on all extremities from 15 min before paclitaxel until 15 min post-infusion every cycle. Efficacy was measured by patient-reported outcomes (Patient Neurotoxicity Questionnaire [PNQ] and EORTC QLQ-CIPN20) and electrophysiological assessments. The primary endpoint was PNQ severity at 2 weeks after 12 cycles of weekly paclitaxel.Results: A total of 46 patients were recruited, of which 8 dropped out before paclitaxel treatment, leaving 38 evaluable. There was no significant difference in PNQ severity between cryotherapy and usual care at 2 weeks after paclitaxel treatment (sensory: p = 0.721; motor: p = 1.000). A benefit was observed at 3 months post-paclitaxel based on PNQ (sensory: 14.3 vs. 41.2%, p = 0.078; motor: 0 vs. 29.4%, p = 0.012) and CIPN20 (sensory: β = −3.6, 95%CI = −10.5–3.4, p = 0.308; motor: β = −7.3, 95%CI = −14.6–0, p = 0.051). Additionally, cryotherapy subjects have lower CIPN20 autonomic score (β = −5.84, 95%CI = −11.15 to −0.524, p = 0.031) and higher sympathetic skin response hand amplitudes (β = 0.544, 95%CI = 0.108–0.98, p = 0.014), suggesting possible autonomic benefits from cryotherapy. Temporary interruption with cryotherapy occurred in 80.9% of the subjects due to cold intolerance.Conclusions: There is insufficient evidence that cryotherapy prevents sensory neuropathy which may be due to the high rates of cryotherapy interruption in this study. The autonomic benefits of cryotherapy should be further investigated with appropriate outcome measures.Clinical Trial Registration:ClinicalTrials.gov: NCT03429972.

show abstract

“…No serious adverse effects were associated with cryotherapy although one patient discontinued cryotherapy halfway through cycle 3 due to cold-induced pain. 21…”

Section: Resultsmentioning

confidence: 99%

Cryotherapy for the prevention of chemotherapy-induced peripheral neuropathy: A systematic review

Bailey

Brown

Hammond

2020

J Oncol Pharm Pract

View full text Add to dashboard Cite

Objective Chemotherapy induced peripheral neuropathy (CIPN) is an adverse effect of certain chemotherapy agents that can result in dose reductions, permanent nerve damage, and chronic pain. Although pharmacological agents have been studied in this setting, there is no standard of care for the prevention of CIPN. Thus, the objective of this systematic review is to assess the efficacy and safety of cryotherapy for the prevention of CIPN. Data sources PubMed (1946 to February 2020) and Embase (1947 to February 2020) were utilized to conduct a literature search using the following search terms: antineoplastic agent(s), taxoid(s), or chemotherapy and neuralgia, peripheral nervous system diseases, peripheral neuropathy, or paclitaxel-induced peripheral neuropathy and cryotherapy, cryotherapy device, hypothermia, low temperature procedures, or ice. Data summary A total of 11 studies were included in the final assessment. Results of this systematic review indicate that the efficacy of cryotherapy in preventing CIPN is conflicting. This may be due to studies utilizing differing cryotherapy administration methods, study design, and including only a small number of patients. All included studies utilized cryotherapy with taxane-based chemotherapy treatments and cooling gloves and socks was the most common method of administration. Overall, cryotherapy was well-tolerated and no serious adverse effects were noted. Conclusions Due to the absence of serious adverse effects, cryotherapy is a reasonable option to consider to prevent CIPN in patients receiving taxane-based chemotherapy. However, additional research is needed, including larger, better designed studies, to fully delineate the role of cryotherapy for CIPN.

show abstract

The effectiveness of regional cooling for paclitaxel-induced peripheral neuropathy

Cited by 27 publications

References 31 publications

Safety and tolerability of cryocompression as a method of enhanced limb hypothermia to reduce taxane-induced peripheral neuropathy

Safety and tolerability of cryocompression as a method of enhanced limb hypothermia to reduce taxane-induced peripheral neuropathy

Impact of Cryotherapy on Sensory, Motor, and Autonomic Neuropathy in Breast Cancer Patients Receiving Paclitaxel: A Randomized, Controlled Trial

Cryotherapy for the prevention of chemotherapy-induced peripheral neuropathy: A systematic review

Contact Info

Product

Resources

About