Comparison of the efficacy of cryotherapy and compression therapy for preventing nanoparticle albumin-bound paclitaxel-induced peripheral neuropathy: A prospective self-controlled trial

Abstract

Background

Recently, the efficacy of cryotherapy and compression therapy to prevent taxane-induced peripheral neuropathy has been reported. We prospectively compared the efficacy of cryotherapy using a frozen glove (FG) and compression therapy using a surgical glove (SG) to prevent nanoparticle albumin-bound paclitaxel (nab-PTX)-induced peripheral neuropathy.

Patients and methods

Breast cancer patients who received 260 mg/m ² of nab-PTX were eligible to participate in this trial. Patients wore a FG on one hand (60 min) without changing and two SGs of the same size (i.e., one size smaller than the size that best fit their hand) on the other hand (90 min) during chemotherapy. Peripheral neuropathy was evaluated at each treatment cycle using Common Terminology Criteria for Adverse Events (CTCAE) version 4.0, the Patient Neurotoxicity Questionnaire (PNQ), and the Functional Assessment of Cancer Therapy-Taxane subscale. Temperatures at each fingertip in both groups were measured thermographically.

Results

Between August 2017 and March 2019, 43 patients were enrolled and 38 were evaluated. No cases showed discordance of peripheral neuropathy between each gloved group in cases of CTCAE $\ge$ grade 2. In cases of PNQ $\ge$ grade D, using the Nam equivalence test, the upper test ( P = 0.0329) and lower test ( P = 0.0052) both showed negative results in comparisons between each gloved group. Fingertip temperature was significantly lower in the FG group than in the SG group after treatment ( P < 0.0001).

Conclusions

It seems to be no difference in incidence of nab-PTX-induced peripheral neuropathy using either cryotherapy or compression therapy.

Highlights

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  Phase II, self-controlled clinical trial, in breast cancer patients.

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  Prospectively compared the efficacy of cryotherapy and compression therapy for CIPN.

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  Evaluated efficacy and safety of surgical glove (SG) and frozen glove (FG) for CIPN.

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  In both FG and SG groups, frequencies of Grade 2 or higher CIPN was 18.4%.

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  Cryotherapy and compression therapy show comparable efficacy in preventing CIPN.