Pharmacy Service, Durham Veterans Affairs Health Care System, Durham, NC, USA.
J Oncol Pharm Pract. 2021 Jan;27(1):156-164. doi: 10.1177/1078155220959431. Epub 2020 Sep 21.
Chemotherapy induced peripheral neuropathy (CIPN) is an adverse effect of certain chemotherapy agents that can result in dose reductions, permanent nerve damage, and chronic pain. Although pharmacological agents have been studied in this setting, there is no standard of care for the prevention of CIPN. Thus, the objective of this systematic review is to assess the efficacy and safety of cryotherapy for the prevention of CIPN.
PubMed (1946 to February 2020) and Embase (1947 to February 2020) were utilized to conduct a literature search using the following search terms: antineoplastic agent(s), taxoid(s), or chemotherapy and neuralgia, peripheral nervous system diseases, peripheral neuropathy, or paclitaxel-induced peripheral neuropathy and cryotherapy, cryotherapy device, hypothermia, low temperature procedures, or ice.
A total of 11 studies were included in the final assessment. Results of this systematic review indicate that the efficacy of cryotherapy in preventing CIPN is conflicting. This may be due to studies utilizing differing cryotherapy administration methods, study design, and including only a small number of patients. All included studies utilized cryotherapy with taxane-based chemotherapy treatments and cooling gloves and socks was the most common method of administration. Overall, cryotherapy was well-tolerated and no serious adverse effects were noted.
Due to the absence of serious adverse effects, cryotherapy is a reasonable option to consider to prevent CIPN in patients receiving taxane-based chemotherapy. However, additional research is needed, including larger, better designed studies, to fully delineate the role of cryotherapy for CIPN.
化疗引起的周围神经病（CIPN）是某些化疗药物的一种不良反应，可导致剂量减少、永久性神经损伤和慢性疼痛。虽然已经研究了药理学药物在这种情况下的作用，但对于 CIPN 的预防尚无标准治疗方法。因此，本系统评价的目的是评估冷冻疗法预防 CIPN 的疗效和安全性。
使用以下搜索词在 PubMed（1946 年至 2020 年 2 月）和 Embase（1947 年至 2020 年 2 月）进行文献检索：抗肿瘤剂（taxoid(s)）、紫杉烷类或化疗和神经痛、周围神经系统疾病、周围神经病或紫杉醇诱导的周围神经病和冷冻疗法、冷冻疗法设备、低温疗法、低温处理或冰。
共有 11 项研究最终纳入评估。本系统评价的结果表明，冷冻疗法预防 CIPN 的疗效存在争议。这可能是由于研究采用了不同的冷冻疗法给药方法、研究设计以及仅纳入了少数患者。所有纳入的研究均使用冷冻疗法联合紫杉烷类化疗治疗，且最常见的给药方法是使用冷却手套和袜子。总体而言，冷冻疗法耐受性良好，未观察到严重不良事件。
由于冷冻疗法没有严重的不良事件，因此对于接受紫杉烷类化疗的患者，考虑使用冷冻疗法预防 CIPN 是合理的选择。然而，需要开展更多研究，包括更大规模、设计更好的研究，以充分阐明冷冻疗法在 CIPN 中的作用。
