Efficacy of temperature-controlled hand-foot cryotherapy to prevent chemotherapy-induced polyneuropathy (CIPN): 1-year follow-up of a single-center, prospective, real-world data collection.

Abstract

e24074 Background: Advancements in oncology have significantly improved the overall survival of patients with cancer, particularly those with breast cancer. Consequently, managing the long-term side effects of chemotherapy, an essential component of cancer treatment, on quality of life (QoL) has become increasingly important. Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent adverse effect of taxane-based treatments (paclitaxel, nab-paclitaxel, and docetaxel) that negatively affects patients’ QoL. CIPN can further lead to dose delays, reductions, or even treatment discontinuation. Recent data suggest that temperature-controlled hand-foot cooling (Hilotherapy) is effective in preventing CIPN (Oneda et al., 2020, 2021; Coolbrandt et al., 2022). The introduction of second-generation cuffs, which improve skin contact and enhance cooling, raises questions about the necessity of the recommended 30-minute post-cooling period. Methods: We implemented prophylactic Hilotherapy using second-generation cuffs as a standard of care during chemotherapy, while omitting the post-cooling period due to capacity constraints. The efficacy and patient satisfaction with Hilotherapy in preventing CIPN were assessed through surveys. Participants were stratified based on chemotherapy dosing schedules (weekly [q1w] vs. every three weeks [q3w]). Results: A total of 181 breast cancer patients completed taxane-based chemotherapy. At the end of treatment 93,4% of the patients exhibited mild or no CIPN symptoms (grade 0–1), while 6,6% reported CIPN grade 2. No grade 3 toxicity was observed. At the 1-year follow-up, 86.7% of patients continued to report mild or no CIPN symptoms (grades 0–1), whereas 2,8% experienced CIPN grade 2 symptoms. 10.5% of all patients were either lost to follow-up or died. No cases of grade 3 CIPN have been reported. Conclusions: The 1-year follow-up data confirmed the long-term sustainability of the protective effect of Hilotherapy in CIPN prevention. The use of second-generation cuffs further optimized the cooling effect even without the post-cooling period. These findings suggest that omitting the post-cooling phase may not compromise the efficacy of this intervention, thus providing a practical and effective approach for CIPN prevention in routine clinical practice.