Safety and efficacy of cryotherapy in the prevention and treatment of chemotherapy-induced peripheral neuropathy

BackgroundChemotherapy-induced peripheral neuropathy (CIPN) is a frequent complication of several chemotherapies (CTs) used in clinical practice. Preventing its onset is important since it may require CT dose reductions, early treatment discontinuation, and can impact on the well-being of patients. There is no effective strategy for CIPN management so far. Few studies have been conducted to analyze cryotherapy in CIPN prevention and treatment, and the results are controversial. Therefore, more data are needed to clarify cryotherapy’s role in this context.MethodsThis is a retrospective analysis of patients treated with potentially neurotoxic agents at a single Brazilian institution between December 2019 and January 2024, aiming the efficacy and safety of cryotherapy in the prevention and treatment of CIPN. Cryotherapy was administered by the Hilotherm Clinic Chemo HT02 device. A questionnaire was administered every cycle to assess CIPN symptoms. Palmar-plantar erythrodysesthesia (PPE) was classified according to the Common Terminology Criteria for Adverse Events, version 5.0.ResultsOf the 207 patients analyzed, 117 (56.5%) underwent a taxane-based regimen and 90 (43.5%) received a platinum-based drug. The median duration of cryotherapy treatment was 1.4 months. The chemotherapy was initiated alongside cryotherapy in 117 patients. The median number of cryotherapy sessions was 4 (ranging from 1 to 31), and, when excluded patients who underwent only one session of cryotherapy (n=40), the median was 6. 72 patients completed the cryotherapy and treatment was ongoing in 14. The main reason for treatment discontinuation was patient decision (96 [46.4%]), and 32 of these patients did so after the first session of cryotherapy. Of the 167 patients that underwent more than one session of cryotherapy, CIPN, PPE and onycholysis were stable or better than the baseline status in 94.6%, 98.8%, and 100%, respectively. The percentage of patients with stable or improved CIPN was higher than 90% for most of the CIPN related symptoms.ConclusionsCryotherapy is a safe, tolerable and efficient approach to prevent and treat CIPN. Prospective randomized trials are needed to confirm the efficacy of cryotherapy in this context.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.