In a meta-analysis reported in the journal Breast Cancer Research and Treatment, Kumar et al found that the use of cryotherapy decreased the incidence of moderate or worse peripheral neuropathy by more than 50% in patients with breast cancer who received paclitaxel or nab-paclitaxel. Cryotherapy with taxane infusion may thus represent an efficacious noninvasive strategy for the prevention of this chemotherapy-induced neurotoxicity.
Study Details
The investigators conducted a systematic search, initially identifying 477 records. The titles were screened independently by two reviewers. A total of 14 studies were ultimately included in the meta-analysis, which was conducted using a meta package in a statistical programming language. The analysis was restricted to studies that evaluated cryotherapy in patients with breast cancer who received paclitaxel or nab-paclitaxel.
Key Findings
The incidence of Common Terminology Criteria for Adverse Events (CTCAE) grade 2 or higher peripheral neuropathy was 24.9% (n = 81 of 326) with cryotherapy vs 42.4% with placebo (n = 72 of 170); the overall relative risk was 0.45 (P = .0031). For sensory and motor peripheral neuropathy, the relative risks were 0.19 (P = .009) and 0.18 (P = .0491), respectively. The relative risk for having a Patient Neurotoxicity Questionnaire score of at least D, which indicates severe neuropathy, was 0.24 (P = .0035). Cold intolerance was the most frequently reported adverse effect (n = 37 of 247; 15%).
“The use of cryotherapy decreased the occurrence of CTCAE grade 2 [or higher] peripheral neuropathy by 55%,” the investigators concluded. “Cold intolerance was the most frequently reported adverse effect associated with cryotherapy, but this adverse effect did not lead to high discontinuation rates.”
Prashanth Ashok Kumar, MD, FACP, of Upstate University Hospital, Syracuse, New York, is the corresponding author of the Breast Cancer Research and Treatment article.
Disclosure: The study was funded by Upstate Medical University. For full disclosures of the study authors, visit link.springer.com.
