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Comparative Study
. 2024 Jul 27;32(8):554.
doi: 10.1007/s00520-024-08737-3.

Prevention of taxane chemotherapy-induced nail changes and peripheral neuropathy by application of extremity cooling: a prospective single-centre study with intrapatient comparison

Kristen Johnson  1   2 , Barbara Stoffel  1 , Michael Schwitter  1 , Stefanie Hayoz  3 , Alfonso Rojas Mora  3 , Angela Fischer Maranta  1 , Tämer El Saadany  1 , Ursula Hasler  1 , Roger von Moos  1 , Annalea Patzen  1 , Michael Mark  1 , Gillian Roberts  1 , Richard Cathomas  4   5
Affiliations
Comparative Study

Prevention of taxane chemotherapy-induced nail changes and peripheral neuropathy by application of extremity cooling: a prospective single-centre study with intrapatient comparison

Kristen Johnson et al. Support Care Cancer. .

Abstract

Purpose: Common side effects of taxane chemotherapy are nail toxicity and peripheral neuropathy (CIPN) causing severe impact on the quality of life. Different methods of cryotherapy to prevent these side effects have been tested. We investigated the use of machine-controlled cooling of hands and feet to reduce nail toxicity and CIPN in patients receiving taxane chemotherapy.

Methods: Patients receiving Docetaxel (planned dose ≥ 300 mg/m2) or Paclitaxel (planned dose ≥ 720 mg/m2 - ) in the adjuvant or palliative setting of different cancers were included. The dominant hand and foot were cooled to approximately 10 °C using the Hilotherapy machine. The contralateral hand and foot were used as intrapatient comparison. The primary endpoint was the occurrence of any CIPN due to paclitaxel or nail toxicity due to Docetaxel. Both the intention to treat population (ITT) and the per protocol population (PPP) were analyzed.

Results: A total of 69 patients, 21 treated with Docetaxel and 48 with Paclitaxel, were included at our centre between 08/2020 and 08/2022. Nail toxicity due to Docetaxel was overall not significantly improved by cooling in the ITT or PPP but a significant benefit across visits was found for the ITT. CIPN due to Paclitaxel was numerically better in the ITT and significantly better in the PPP. A significant benefit of cooling on CIPN occurrence across visits was found for the ITT and the PPP. Cooling was very well tolerated.

Conclusion: Cooling of hands and feet has a clinically meaningful impact on reducing occurrence of CIPN and nail toxicity on treatment with taxanes. Effects are more significant over time and are dose dependent.

Trial registration number: 2020-00381. Date of registration. 24th February 2020.

Keywords: Chemotherapy-induced polyneuropathy (CIPN); Docetaxel; Hilotherapy; Nail changes; Paclitaxel.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Proportion of patients experiencing pathological nail changes in the cooled vs. not cooled hand/foot by visit under Docetaxel chemotherapy (ITT, N = 21)
Fig. 2
Fig. 2
Proportion of patients experiencing CIPNs in any extremity in the cooled vs. not cooled hand/foot by visit under Paclitaxel chemotherapy (ITT, N = 46)
See this image and copyright information in PMC

References

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