Peripheral Neuropathy And Nail Dystrophy Induced By Taxanes: The Impact Of Cryotherapy On The Prevention And Control Of Symptoms

Chemotherapy-induced peripheral neuropathy (CIPN) and nail disorders (ND) are highly prevalent in patients treated with taxanes. We aimed to evaluate the effectiveness of using frozen gloves (FG) in the prevention of these symptoms and their prevalence in breast cancer patients during treatment. Prospective and unicentric self-controlled study. Breast cancer patients treated with taxanes regimen in monotherapy (Paclitaxel 80mg/m2 every 7 days or Docetaxel 100 mg/m2 every 21 days) wore FG in the dominant hand during the drug infusion. From September 2020 to February 2021, in a 2-point assessment: baseline (T0) and end of chemotherapy (CT)(T1), CIPN was measured with the validated Total Modified Neuropathy Score (mTNS) and self-reported questionnaires: FACT / GOG-NT and EORTC QLQ - CIPN20; ND were evaluated with the Common Toxicity Criteria of the National Cancer Institute. We included 63 women with a median age of 59 +/- 11.7 years, 2 withdrew due to cold intolerance. In total, patients completed a median of 6 CT cycles, 43 with paclitaxel regimen. The incidence of CIPN was statistically lower in the FG hand at T1 with a median mTNS (score range (sr) 0-24) of 1 [1.0-1,5] vs 4 [2.2-5.4] in the control hand. The table represents scores incidence of CIPN and its negative impact on the quality of life (QoL) of the patients. FG also reported significantly lower ND at T1 (p <0.001): Onycholysis was Grade (G) 0 in 77.8% (FG) vs 42.9% (Control), G1-2 in 22.2% vs 57.1%; Paronychia G0 in 95.2% vs 80.9%, G1-2 in 5.0% vs 19.0%; hyperpigmentation G0 in 98.4% vs 85.7%, G1-2 in 2.0% vs 14.3%. The median time of onset of nail changes was 62.3 vs 41.7 days, for FG and control hand respectively. Outcomes (median, [interval]).Table: 1719PT0T1pFACT/GOG-NTX Physical well-being (sr 0-28)1 [1.3-2.2]13 [12.0-13.5]0.001Functional well-being (sr 0-28)18 [17.8-18.7]22 (22,3-23,1)0.048Neuropathy (sr 0-44)0 [0.3-0.9]9 [8.4-9.7]0.001EORTC QLQ-CIPN20 (sr 18-72)26 [25.2-26.3]41 [40.5-42.8]0.001 Open table in a new tab Our data shows the high prevalence of CIPN and ND in patients under taxanes. The use of FG demonstrated a benefit in reducing symptoms of neuropathy or nail toxicity and provides a new tool in supportive care management to improve patient's QoL.