Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California Irvine, Irvine, CA, USA.
Department of Pharmacy, University of California Irvine Health, Irvine, CA, USA.
Support Care Cancer. 2022 Dec;30(12):10001-10007. doi: 10.1007/s00520-022-07383-x. Epub 2022 Oct 10.
Chemotherapy-induced peripheral neuropathy (CIPN) is a serious side effect that is highly prevalent among cancer patients undergoing chemotherapy. There is a growing use of cryotherapy (CryTx) and compression therapy (ComTx) to prevent CIPN at cancer centers worldwide. In this study, we examined the awareness and recommendation of these modalities and evaluated factors associated with awareness. In addition, we investigated the type of technology utilized, barriers to implementation, and perceived adverse events of CryTx and ComTx.
Active members of the Multinational Association of Supportive Care of Cancer (MASCC) were invited to complete an electronic survey that was sent via SurveyMonkey between September and October 2021. The survey assessed participants' awareness, recommendation, usage, barriers to utilization, and perceived adverse events of CryTx and ComTx. Descriptive statistics and multiple logistic regression were utilized to analyze findings.
Out of 184 participants, 70.1% were physicians, 73.4% had over 10 years of practice, and 49.5% were practicing in an outpatient setting. While more than half (63.3%) of participants indicated awareness of CryTx for taxane-induced peripheral neuropathy, less than a quarter (22.8%) indicated recommendation in their practice setting. Factors associated with higher awareness of CryTx for patients receiving taxanes include living in Europe (OR = 2.69, 95% CI [1.28-5.64], p = 0.009), not practicing in an inpatient setting (OR = 3.15, 95% CI [1.45-6.85], p = 0.004), and self-identifying as non-physician (OR = 2.40, 95% CI [1.03-4.37], p = 0.041). Commercial cooling (31.5%) and compression (16.8%) gloves and socks were the most used modalities for CryTx and ComTx, respectively. The most identified barriers to CryTx and ComTx utilization include insufficient evidence (53.5%), logistics (34.8%), and patient discomfort (23.4%). Redness/irritation of skin (27.7%) and numbness/tingling (24.5%) accounted for about half of the perceived adverse events associated with use of CryTx and ComTx.
Results of our global survey illustrated that there are varying modes in the delivery of CryTx and ComTx among cancer centers around the world. Education of the utilization of CryTx and ComTx, in addition to efficacy and implementation studies, is needed to close the gap between awareness and implementation in clinical practice.
化疗引起的周围神经病（CIPN）是癌症患者在化疗过程中普遍存在的严重副作用。全球许多癌症中心越来越多地使用冷冻疗法（CryTx）和压缩疗法（ComTx）来预防 CIPN。在这项研究中，我们检查了对这些方法的认识和推荐情况，并评估了与认识相关的因素。此外，我们还调查了 CryTx 和 ComTx 使用的技术类型、实施障碍以及感知的不良事件。
多国支持癌症护理协会（MASCC）的活跃成员被邀请完成一份电子调查，该调查于 2021 年 9 月至 10 月期间通过 SurveyMonkey 发送。该调查评估了参与者对 CryTx 和 ComTx 的认识、推荐、使用、使用障碍和感知不良事件。使用描述性统计和多逻辑回归分析结果。
在 184 名参与者中，70.1%为医生，73.4%有超过 10 年的实践经验，49.5%在门诊环境中执业。尽管超过一半（63.3%）的参与者表示对紫杉烷类药物引起的周围神经病的 CryTx 有认识，但只有不到四分之一（22.8%）表示在其治疗环境中推荐使用。与接受紫杉烷类药物治疗的患者对 CryTx 的认识较高相关的因素包括居住在欧洲（OR=2.69，95%CI[1.28-5.64]，p=0.009）、不在住院环境中执业（OR=3.15，95%CI[1.45-6.85]，p=0.004）和自我认定为非医生（OR=2.40，95%CI[1.03-4.37]，p=0.041）。商业冷却（31.5%）和压缩（16.8%）手套和袜子是 CryTx 和 ComTx 最常用的方法。CryTx 和 ComTx 应用的最大障碍包括证据不足（53.5%）、后勤（34.8%）和患者不适（23.4%）。皮肤发红/刺激（27.7%）和麻木/刺痛（24.5%）约占与使用 CryTx 和 ComTx 相关的不良事件的一半。
我们的全球调查结果表明，世界各地的癌症中心在提供 CryTx 和 ComTx 方面存在不同的模式。需要对 CryTx 和 ComTx 的使用进行教育，包括疗效和实施研究，以缩小认识与临床实践实施之间的差距。
