Coverings avoid frostbites and do not reduce efficacy of cryotherapy for prevention of chemotherapy-induced neuropathy

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent and disabling side effect of cancer treatment. In a self-controlled trial, we evaluated preventive effects of cryotherapy and concluded it was useful for preventing both the objective and subjective symptoms of CIPN. The patients used coverings to reduce the cold discomforts, and there was no dropout due to cold intolerance or frostbite. However, coverings might interfere with the skin temperature falls and the effects of cryotherapy. Therefore, we evaluated the impact of coverings on them. Methods: Breast cancer patients who were planned to undergo weekly paclitaxel (80 mg/m2 for 1 hour) for an at least cumulative dose of 960mg/m2 were enrolled. The exclusion criteria were peripheral neuropathy, neuralgia or edema (CTCAE grade > 1); tumor metastasis in bone, soft tissue, or skin of the hands or feet; Raynaud's symptoms; peripheral arterial ischemia; hand-foot syndrome; and any other reasons based on the primary physician's judgment. Each patient wore frozen gloves and socks on the dominant hand and foot, and the non-dominant side acted as the untreated control. The nonwoven fabric inner covers were applied when the patients complained of cold pain. The patients were divided into covering or non-covering group then CIPN symptoms were compared to the control side. Results: Forty patients were included in the subgroup analysis with the hazard ratio (HR). Cryotherapy with covering was also sufficient to prevent CIPN [covering and non-covering; Objective, hand:0.00(P