Novel Frostbite Cooling Device for Real-time Assessment and Prevention of Chemotherapy-induced Peripheral Neuropathy

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) affects 29%-68% of patients undergoing anticancer treatments within the first month. Traditional cryotherapy methods, such as frozen gloves, can pose risks. This study evaluates the cool-water electric circulation seat (CECS), which maintains a constant 15°C, as a safer alternative.

Methods: In this prospective study, 21 healthy Japanese adults underwent 2.5 hours of hand cooling at 15°C, reflecting the standard duration of taxane anticancer drug administration. Microcirculation was evaluated using videocapillaroscopy before and after cooling.

Results: Results showed significant reductions in blood vessel area and altered red blood cell movement postcooling. Finger temperature and vascular area decreased significantly (P < 0.001), and red blood cell movement changed significantly, with most cells shifting from slow (52.4%) or fast (47.6%) movement before cooling to slow (23.8%) or immobile (76.2%) afterward (P < 0.001). Thirty minutes postcooling, 38.1% of participants reported temporary redness, and 28.6% reported pain, both resolving by the next day.

Conclusions: The CECS effectively provides secure cooling, offering a promising approach for CIPN prevention without frostbite risk. These findings highlight the potential advantages of CECS in sustained cooling therapy for CIPN prevention.

Fig. 1.

The CECS boasts a very slender profile, measuring only 4 mm of thickness, and features lightweight construction, tipping the scales at 640 g. This state-of-the-art seat incorporates an innovative water circulation system. The temperature control span ranges from 15° to 41°C, with the ongoing water circulation guaranteeing steadfast temperature management. Notably, the overall device weight was 1700 g, confirming its exceptional portability.

Fig. 2.

The GOKO Bscan-ZD videocapillaroscope served as the apparatus for observing capillaries in the skin flap. The camera field covered 0.35 mm²/point, reaching a depth of 1mm from the surface. Remarkably lightweight at 140 g, it allowed for effortless single-handed operation. The observations were conducted at approximately 175× and 620× magnification, boasting a resolution of 1.2 million pixels.

Fig. 3.

Cooling was executed, utilizing docetaxel administration as the conceptual framework, encompassing a total cooling duration of 2.5 hours. This cooling protocol comprised a 30-minute predose cooling phase, simultaneous cooling throughout the entire period of docetaxel administration (1 h), and postadministration cooling lasting approximately 1 hours. The primary objective of this investigation was to assess the impact of the cooling regimen on the half-life (t₁/₂) of docetaxel.

Fig. 4.

The cooling procedure reduced the hand surface temperature from 36.4° to 23.4°C and significantly reduced the vascular area. Similarly, the finger surface temperature decreased from 36.5° to 22.5°C, and the vascular area decreased significantly.

Fig. 5.

A remarkable shift commenced at an initial superficial finger temperature of 36.129° ± 0.299°C, demonstrating a significant decrease to 24.043° ± 1.735°C postcooling. This compelling thermal modulation underscores the cooling intervention’s efficacy, resulting in a noteworthy reduction in the surface temperature of both hands and fingers.

Fig. 6.

The initial blood vessel area shifted substantially from 11.2% ± 2.88% before cooling to 3.848% ± 1.621% postcooling (P < 0.001). Cooling reduced the vascular area significantly in the hands and fingers.