186P Using a new controlled thermotherapy (Hilotherapy®) during chemotherapy prevents chemotherapy induced polyneuropathy (CIPN)

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is an adverse effect of many commonly used chemotherapeutic agents, especially taxane-based regimen (Paclitaxel, nab-Paclitaxel, Docetaxel). CIPN reduces patients health-related quality of life for years and often results in dose delay, dose reduction or treatment discontinuation. The prophylactic use of controlled thermotherapy (Hilotherapy®) prevents CIPN. 168 breast cancer patients used a new method of physical thermotherapy, a device equiped with hand and foot cuffs to allow a constant cooling. Cooling medium is demineralized water. Continous cooling of hands and feet was performed 30 minutes before to 60 minutes after completing drug infusion with a temperature of 10-12°C. CIPN symptoms were evaluated after each cytotoxic cycle using common terminology criteria for adverse events (CTCAE). Sustainability of the impact was assessed by long-term datas (every 3 months). 130 patients used the prophylactic Hilotherapy® for each cytotoxic treatment (Group 1: primary Prophylactic Hilotherapy® - pPHT). 38 patients used reactive secondary Hilotherapy (Group 2: rSHT). Hands and feet were cooled after onset of symptoms of CIPN (grade 1-3). Group pPHT: Out of 130 patients who used pPHT, 121 patients (93%) developed none or mild symptoms of CIPN (grade 0-1). 8 patients (6,1%) reported grade 2, 1 patient grade 3 (0,8%) toxicity. The symptoms of CIPN were reversible. 4 months after chemotherapy, 98% of the patients had no CIPN > grade 1. 2 patients (2%) suffered intermittent toxicity grade 2. Follow Up datas confirmed the results. Group rSHT: Without using pPHT 50% of the patients developed grade 3 and 2 CIPN. Using rSHT progression was stopped and reduction of toxicities was reached: at last chemotherapy treatment grade 2 & 3 toxicities were reduced from 50% to 25%. Prophylactic Hilotherapy prevented symptoms > grade 1 in 93% of patients. 4 months after chemotherapy treatment, 98% of the patients were without limiting symptoms > grade 1. No dose modifications or treatment interruptions had been necessary. Without pPHT, 50 % of the patients developed CIPN grade 2-3. rSHT stopped progression of CIPN and reduced first symptoms of CIPN.