The Relationship Between the Grade of Peripheral Neuropathy and the Skin Blood Perfusion in Chemotherapy-Induced Peripheral Neuropathy Patients, and the Effects of Compression Therapy

Abstract

ABSTRACT Aim: Nanoparticle albumin-bound paclitaxel (nab-PTX) has become a key drug used in chemotherapy for breast cancer, but it often causes adverse effects such as peripheral neuropathy (PN). No effective prophylactic management has so far been established. We have applied a “3S” approach to prevent and treat PN based on two concepts: compression therapy using stockings and sleeves, and medication therapy using selected prophylactic medications. We previously reported better CTCAE v4.0 grades and notably superior nab-PTX dose maintenance in a 3S group compared to a control group with no prophylactic treatment. However, little is known about the effects of compression therapy on the relationship between PN and the skin blood perfusion. Methods: The skin perfusion of the lower limbs was measured before and after stocking use in a 3S prophylactic treatment group for nab-PTX therapy (n = 50), and in a control group of healthy volunteers (n = 50). The 3S group was subdivided by PN grade for a subsequent analysis (n = 18 for Grade 0, n = 22 for Grade 1 and n = 10 for Grades 2 and 3 combined). The skin perfusion was measured using a laser Doppler blood flow meter with an integrated probe (NL-101 Nahri Nexis Japan). Results: In the control group of healthy volunteers, stocking use tended to increase the median skin perfusion level (mL/min/100g) from 10.9 ± 3.8 to 11.8 ± 4.3. Interestingly, the median skin perfusion level for the 3S group as a whole significantly increased from 8.7 ± 3.3 before stocking use to 11.3 ± 3.8 after stocking use (p Conclusions: This study demonstrated that the skin perfusion of the lower limbs is decreased following nab-PTX chemotherapy, and also that compression therapy can successfully restore the skin perfusion levels in nab-PTX patients across every grade of peripheral neuropathy. This apparent restoration in skin perfusion may increase the drug clearance, which could potentially alleviate peripheral neuropathy. Disclosure: All authors have declared no conflicts of interest.