Hanai Akiko
National Cancer Center Japan.
Nihon Yakurigaku Zasshi. 2019;154(5):245-248. doi: 10.1254/fpj.154.245.
Chemotherapy induced peripheral neuropathy (CIPN) is a numbness or tingling of the hands and feet that occur as a side effect of anticancer drugs including taxanes and platinum drugs. The effective treatments or preventive strategy are not established. Once it develops, symptoms persist for a long time and cause impairment in activity of daily living. Topical cooling is a preventive strategy for side effects of chemotherapy such as hair loss, oral microsites, and skin and nail disorder of the hands and feet. We conducted a clinical trial in breast cancer patients who received paclitaxel treatment to assess the effectiveness of cooling for CIPN prevention. In this study, the individual background factor was standardized using an intra-individual comparison design. In 40 subjects, frozen gloves and socks were applied on the dominant hand and foot from 15 minutes before the anti-cancer drug administration to 15 minutes after the end of administration (total 90 minutes) and compared with non-dominant hand and foot. As a result, clinically and statistically significant differences were observed for changes in tactile threshold evaluated by the monofilament test, subjective symptoms, and changes in dexterity evaluated by functional test. The current cooling system has not been well implemented in oncology field due to the lack of facility and human resources. To deliver this therapy broadly, it will be urgent to develop a medical cooling device that can provide safe and effective cryotherapy.
化疗引起的周围神经病变(CIPN)是手脚出现麻木或刺痛,这是包括紫杉烷类和铂类药物在内的抗癌药物的副作用。目前尚未确立有效的治疗方法或预防策略。一旦发生,症状会持续很长时间,并导致日常生活活动能力受损。局部冷却可作为化疗副作用的预防策略,如脱发、口腔微环境改变以及手脚皮肤和指甲病变。我们对接受紫杉醇治疗的乳腺癌患者进行了一项临床试验,以评估冷却对预防CIPN的有效性。在本研究中,使用个体内比较设计对个体背景因素进行了标准化。在40名受试者中,从抗癌药物给药前15分钟至给药结束后15分钟(共90分钟),在优势手和脚上佩戴冷冻手套和袜子,并与非优势手和脚进行比较。结果,在通过单丝试验评估的触觉阈值变化、主观症状以及通过功能试验评估的灵活性变化方面,观察到了临床和统计学上的显著差异。由于缺乏设施和人力资源,目前的冷却系统在肿瘤学领域尚未得到很好的应用。为了广泛提供这种治疗,迫切需要开发一种能够提供安全有效冷冻疗法的医用冷却设备。