Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
Support Care Cancer. 2022 Jun;30(6):4835-4843. doi: 10.1007/s00520-022-06890-1. Epub 2022 Feb 11.
The primary objective of this study was to investigate the efficacy of cold therapy in reducing paclitaxel-based, chemotherapy-induced, peripheral neuropathy (CIPN). The secondary objective was to establish the incidence of CIPN arising from paclitaxel administration.
The study enrolled gynecological cancer patients who were aged over 18 years and receiving chemotherapy which included paclitaxel (175 mg/m every 3 weeks). The patients were allocated to control and cold-therapy groups by computer randomization. During paclitaxel administration, frozen gloves developed in-house by Siriraj Hospital were worn-with a cold pack inside-on both hands and both feet by the cold-therapy patients. The CIPN incidence was evaluated by FACT/GOG-Ntx (version 4) at each chemotherapy cycle and at the 1-month follow-up after treatment completion.
There were 79 patients (control arm, 40; study arm, 39). The CIPN incidences in the control and cold-therapy groups were 100% and 48.7%, respectively. CIPN was significantly decreased in the intervention group between the first cycle and the 1 month follow-up after chemotherapy cessation (P value < 0.001). Four patients discontinued the cold therapy due to pain, but there were no serious adverse effects due to the therapy.
The Siriraj Hospital, in-house-developed, frozen gloves can reduce CIPN effectively as part of cold therapy for paclitaxel-based chemotherapy. The benefits of using the gloves are apparent from the first chemotherapy cycle to the 1-month, post-treatment follow-up assessment.
本研究的主要目的是探究冷疗对减轻紫杉醇为基础的化疗引起的周围神经病变(CIPN)的疗效。次要目的是确定紫杉醇给药引起的 CIPN 发生率。
该研究纳入了年龄在 18 岁以上且接受包含紫杉醇(每 3 周 175mg/m²)的化疗的妇科癌症患者。通过计算机随机化将患者分配到对照组和冷疗组。在紫杉醇给药期间,冷疗组的患者将由 Siriraj 医院自制的冷冻手套戴在双手和双脚上,手套内装有冰袋。在每个化疗周期和治疗完成后 1 个月的随访时,使用 FACT/GOG-Ntx(第 4 版)评估 CIPN 的发生率。
共有 79 名患者(对照组 40 名,研究组 39 名)。对照组和冷疗组的 CIPN 发生率分别为 100%和 48.7%。干预组在化疗停止后的第一个周期和 1 个月随访时,CIPN 显著减少(P 值<0.001)。由于疼痛,有 4 名患者停止了冷疗,但没有因治疗产生严重的不良反应。
Siriraj 医院自制的冷冻手套可以作为紫杉醇为基础的化疗中冷疗的一部分,有效减轻 CIPN。从第一个化疗周期到治疗后 1 个月的随访评估,使用手套的益处明显。