Limb compression therapy and chemotherapy-induced peripheral neuropathy in women with gynecologic cancers: A prospective self-controlled study (NEURO-GLOVE Trial)—Updated long-term analysis.

Abstract

5545 Background: No established strategy prevents taxane-induced CIPN. We evaluated if dual-site mechanical compression reduces CIPN severity at 3 and 6 months post-treatment. Methods: In this prospective, self-controlled study (Dec 2023–Dec 2024), 76 women receiving carboplatin–paclitaxel were enrolled. During infusions, compression was applied to the non-dominant hand (two surgical gloves) and ipsilateral foot (Class II stocking); contralateral limbs served as controls. The primary endpoint was the incidence of Grade ≥2 sensory/motor neuropathy (CTCAE v5.0) at End-of-Treatment (EOT), 3 months, and 6 months. Results: Among 76 patients (median age 61), Grade ≥2 CIPN was lower in compression vs control limbs at Cycle 3 (27/76 [35.5%] vs 41/76 [53.9%]; P=.001) and EOT (45/76 [59.2%] vs 53/76 [69.7%]; P=.021). Benefits persisted at 3 months (22/76 [28.9%] vs 40/76 [52.6%]; P=.015) and 6 months (15/74 [20.3%] vs 25/74 [33.8%]; P=.002). Longitudinal analysis showed significant time-by-limb interactions for hand sensory (P=.003), foot sensory (P=.018), and motor domains (P=.041). EORTC QLQ-CIPN20 sensory scores showed high accuracy (AUC 0.92 at Cycle 3; 0.97 at EOT). Conclusions: Compression significantly reduces acute and persistent CIPN. Sustained benefits at 3 and 6 months suggest prevention of irreversible damage, supporting compression as an effective neuroprotective strategy. Clinical trial information: NCT07105553 . Limb-specific incidence of moderate-to-severe chemotherapy-induced peripheral neuropathy by EORTC QLQ–CIPN20 across time. Time point Limb Moderate–severe CIPN†, n/N (%) Discordant cases ‡, n McNemar p (compression vs control) RD %, Control–Compression (95% CI) P value vs baseline § Baseline CompressionControl 0/76 (0.0)0/76 (0.0) – – – – Cycle 3 Compression Control 27/76 (35.5)41/76 (53.9) Compression only: 2Control only: 16 0.001 +18.4% (4.5 to 32.4) <0.001 <0.001 EOT Compression Control 45/76 (59.2)53/76 (69.7) Compression only: 1Control only: 9 0.021 +10.5% (3.5 to 24.5) <0.001 <0.001 3-month follow-up Compression Control 22/76 (28.9)40/76 (52.6) Compression only: 2Control only: 20 0.015 +23.7% (10.0 to 37.4 <0.001 <0.001 6-month follow-up Compression Control 15/74 ** (20.3)25/74 (33.8) Compression only: 0Control only: 10 0.002 +13.5% (1.5 to 25.4) <0.001 <0.001