Abstract
ObjectivesThe primary objective of this study was to investigate the efficacy of cold therapy in reducing paclitaxel-based, chemotherapy-induced, peripheral neuropathy (CIPN). The secondary objective was to establish the incidence of CIPN arising from paclitaxel administration.Materials and methodsThe study enrolled gynecological cancer patients who were aged over 18 years and receiving chemotherapy which included paclitaxel (175 mg/m2 every 3 weeks). The patients were allocated to control and cold-therapy groups by computer randomization. During paclitaxel administration, frozen gloves developed in-house by Siriraj Hospital were worn—with a cold pack inside—on both hands and both feet by the cold-therapy patients. The CIPN incidence was evaluated by FACT/GOG-Ntx (version 4) at each chemotherapy cycle and at the 1-month follow-up after treatment completion.ResultsThere were 79 patients (control arm, 40; study arm, 39). The CIPN incidences in the control and cold-therapy groups were 100% and 48.7%, respectively. CIPN was significantly decreased in the intervention group between the first cycle and the 1 month follow-up after chemotherapy cessation (P value < 0.001). Four patients discontinued the cold therapy due to pain, but there were no serious adverse effects due to the therapy.ConclusionThe Siriraj Hospital, in-house-developed, frozen gloves can reduce CIPN effectively as part of cold therapy for paclitaxel-based chemotherapy. The benefits of using the gloves are apparent from the first chemotherapy cycle to the 1-month, post-treatment follow-up assessment.
Highlights
The number of gynecological cancer patients is gradually increasing
The current study investigated the efficacy of frozen gloves developed in-house by Siriraj Hospital
There was a statistical difference in the Chemotherapy-induced peripheral neuropathy (CIPN) incidences of the 2 groups: 100% for the control group, versus 48.7% for the cold-therapy group (P < 0.001; Table 2)
Summary
The number of gynecological cancer patients is gradually increasing. The cancer type and its stage determine the treatment, for example, surgery, radiation, or chemotherapy. Especially paclitaxel, are very commonly used for the chemotherapeutic treatment of gynecological cancers, such as ovarian cancer, cervical cancer, and endometrial cancer. Paclitaxel has many frequent side effects, Chemotherapy-induced peripheral neuropathy (CIPN) is one common side effect of taxanes. The symptoms can be either acute or chronic. Some patients develop acute symptoms after the first cycle of chemotherapy. Develop chronic symptoms after treatment completion, leading to disabilities and impaired quality of life [2]. CIPN affects the quality of life through the presence of pain and fatigue, impairment of cognitive function and mental health, and degradation of physical functioning [4]. Peripheral nerve damage can lead to either motor or sensory symptoms. The sensory symptoms are numbness, tingling, and burning pain, which eventually lead to motor symptoms [5].
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