Cryotherapy for Preventing Chemotherapy- Induced Peripheral Neuropathy in Patients with Gynecologic Cancer in Thammasat University Hospital

Abstract

The aim of this study was to determine the effectiveness of cryotherapy in patients who underwent a platinum and taxane based chemotherapy regimen and developed chemotherapy induced peripheral neuropathy (CIPN). This randomized controlled trial was conducted at Thammasat University Hospital, Thailand between June 2021 and Feb 2022. Participants were patients with gynecologic cancer receiving combination chemotherapy ( carboplatin plus paclitaxel). After recruitment, subjects were allocated to either the study or control group. All patients were wrapped with long socks on both legs. The study site leg had a cold pad at 20 degrees Celsius applied to it while the control site leg did not. Before and after chemotherapy administration, all cases were evaluated by patient neurotoxicity questionnaire (PNQ) , tactile sensation (TS) , cold sensation (CS) , warm sensation (WS) , vibration sensation (VS) and proprioceptive sensation (PS). A total of 36 participants (216 cycles) were enrolled with average age of 61.5 years and an average BMI of 24.7kg/m2. Leg discomfort was reduced in the study group (P-value< 0.01) even as the severity increased with each additional chemotherapy course. Tactile sensation was the worst in the group without cryotherapy (control) after the first chemotherapy cycle. Loss of thermal and vibration sensation were observed in the control group. However, change in proprioception not significant. Based on participant interviews, the leg that underwent cryotherapy had better sensation than the leg that did not. All cases participated in the study until completion, there were no participant withdrawals. Conclusion: Cryotherapy done in tandem with a chemotherapy regimen prevented loss of tactile sensation, temperature sensation and vibration perception.