Cryotherapy During Chemo for Breast Cancer May Reduce Neuropathy

Cryotherapy — involving the use of frozen globs and socks — during chemotherapy may reduce the occurrence of moderate or severe peripheral neuropathy in patients with breast cancer, according to findings from a recent analysis.

Peripheral neuropathy, according to the National Institute of Neurological Disorders, is a condition involving damage to the peripheral nervous system, with symptoms such as muscle weakness, painful cramps, muscle shrinking and uncontrolled muscle twitching.

Results from this analysis were presented at the 2023 ASCO Annual Meeting.

Researchers performed an analysis of data from 14 different studies of patients with breast cancer who underwent chemotherapy with paclitaxel or nab-paclitaxel. These studies involved some aspect of cryotherapy into the treatment including comparing it to no cryotherapy.

“Cryotherapy using various cooling devices — like frozen gloves, by decreasing the blood flow to the peripheries — is a non-invasive strategy to prevent peripheral neuropathy,” Prashanth Ashok Kumar, a fellow in the division of hematology-oncology at Upstate Cancer Center in Syracuse, New York, said during the presentation. “However, with the literature so far, its utility has not yet been established. We hope to answer this question through our meta-analysis.”

Peripheral neuropathy considered moderate or worse occurred in 24.85% of patients who underwent cryotherapy compared with 42.35% of those who did not receive the therapy.

During the presentation, Kumar noted that cryotherapy decreased the incidence of moderate or worse peripheral neuropathy by 55%, “and was, thus, statistically significant in reducing the incidence of peripheral neuropathy caused by paclitaxel and nab-paclitaxel in breast cancer patients.”

The most common side effect related to cryotherapy was cold intolerance, which occurred in 15% of patients. Other side effects included fingernail inflammation and skin irritation, which was reported at 0.8% for each.

“The chance of having any (side effect) was 13%, while the chance of having cold intolerance was 12% with cryotherapy use,” Kumar said during the presentation.

Few patients — 5.1% — stopped the use of cryotherapy before its completion. It was noted in the abstract that this effect was driven by one study included in this analysis, during which 10 out of 16 patients stopped the therapy for cold intolerance.

“Given the lack of any serious (side effects), cryotherapy use can, thus, be encouraged,” Kumar concluded in the presentation. “Further studies are, however, needed to establish a standard way of applying cryotherapy in terms of the device to use, the timing of its use and other logistical factors.”

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