They should control for the potentially different impact cooling may have on CIPN in the setting of different chemotherapy drug regimens. Sphar, MSN, APRN, FNP-C, AOCNP ®, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030. By evaluating the findings of the studies reviewed here within categories of “colder” and “less cold,” the evidence presented in these studies suggests that applying a relatively greater degree of regional cooling compared with a lesser degree may confer benefit in reducing the severity of CIPN. Evaluation of the effect of compression therapy using surgical gloves on nanoparticle albumin-bound paclitaxel-induced peripheral neuropathy: A phase II multicenter study by the Kamigata Breast Cancer Study Group. Chemotherapy-induced peripheral neuropathy may result in reduced, suboptimal chemotherapy dosing, discontinuation of the causative agent, or delays in treatment that may decrease the efficacy of treatment ( Bhatnagar et al.

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The significant dropout rate and small final number of subjects in the Griffiths and colleagues study precluded adequate power, by their own analysis, to evaluate the effectiveness of the cooling intervention (2018). Evaluating the impact of chemotherapy-induced peripheral neuropathy symptoms (CIPN-sx) on perceived ability to work in breast cancer survivors during the first year post-treatment. There was evidence to suggest that applying a relatively greater degree of cooling compared with a lesser degree may confer benefit in reducing the severity of CIPN.No two studies used the same profile of measurement tool(s), although the CTCAE was used in two studies as was the PNQ ( Hanai et al. Of note, the 2018 systematic review that examined the use of cooling to prevent chemotherapy-induced dermatologic toxicities reported a single case of frostbite within the eight studies reviewed that used frozen socks or gloves ( Marks et al.

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Five out of the six included studies provided direct application of cooling, using either precooled gloves and socks or a limb-cooling wrap with continuously flowing cooled water supplied to the wrap ( Eckhoff et al. The study by Hanai and colleagues (2018) examined the use of a relatively greater degree of cooling using cooled socks and gloves worn on the dominant hand and foot in a prospective, self-controlled trial of 36 breast cancer patients receiving weekly paclitaxel for at least twelve cycles. Additionally, the difference in the findings by Griffiths and colleagues (2018) compared with findings in the studies by Eckhoff and colleagues (2013), Hanai and colleagues (2018), and Sato and colleagues (2016) may be attributable to the different outcome measurement tools used in the Griffiths and colleagues study.

with only one of the studies, by Griffiths and colleagues (2018), reporting significant cold intolerance. Results related to CIPN severity included reduced occurrence of grades D or E peripheral neuropathy according to the PNQ on the intervention side (hand: 2. Of note, the use of compression, while not a direct method of cooling, was considered in this review to be an indirect method of cooling given the resulting decrease in fingertip temperature documented within the study. Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent, potentially long-lasting side effect of select chemotherapies.

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Multicenter study of a frozen glove to prevent docetaxel-induced onycholysis and cutaneous toxicity of the hand. Inclusion and exclusion criteria varied as related to staging criteria, features of disease, treatment history, and comorbidities. Patients are entitled to understand available options that may reduce their risk of adverse events with peripherally neurotoxic chemotherapy agents.

Advanced practitioners may advise patients that to date, more studies have examined the benefits of applying greater degrees of cooling using cooled socks and gloves than other methods that apply less cooling, and that perhaps as a result, there is more evidence to suggest that applying a relatively greater degree of cooling using the same method may provide more benefit compared with less cooling.