The impact of cold therapy on the incidence and severity of paclitaxel induced peripheral neuropathy: A pilot study

Background: Peripheral neuropathy is a common side effect induced by chemotherapy agents like Cisplatin, Paclitaxel andDocetaxel. At present, there is no preventive strategy available against the development of neuropathy. This pilot study wasperformed to evaluate the feasibility of cold therapy and its impact on the incidence and severity of neuropathy induced bypaclitaxel in a dose dense adjuvant regimen among patients with breast cancer. Methods: All adult female patients with early breast cancer planned to be treated with dose-dense schedule of Adriamycin,cyclophosphamide and Paclitaxel were eligible. Ice boot and glove were applied for the duration of all four Paclitaxel infusionson one side while the contralateral limbs were taken as control. Peripheral neuropathy was evaluated and graded prior to eachPaclitaxel infusion and then at 3 and 6 months post treatment. Results: A total of 23 patients were recruited. Cold therapy was found to be feasible as no patient discontinued the ice glove andboot during Paclitaxel infusions. Neuropathy symptoms were observed more frequently and with higher grade of severity oncontrol limbs compared to experimental side. There were 5 patients who were switched to ice glove and boot therapy after theydeveloped peripheral neuropathy in the control limbs. These patients observed improvement in their symptoms subsequently. Conclusion: Cold therapy appears to be feasible and appears to have some potential to prevent Paclitaxel induced peripheralneuropathy in this pilot study. This role of cold therapy may be further explored and confirmed in future randomized trials.