CYBERMED LIFE - ORGANIC  & NATURAL LIVING

Cybermedlife - Therapeutic Actions Cryotherapy

Cryotherapy for the prevention of weekly paclitaxel-induced peripheral adverse events in breast cancer patients. 📎

Abstract Title: Cryotherapy for the prevention of weekly paclitaxel-induced peripheral adverse events in breast cancer patients. Abstract Source: Support Care Cancer. 2020 Feb 8. Epub 2020 Feb 8. PMID: 32036471 Abstract Author(s): Hideo Shigematsu, Taizo Hirata, Mai Nishina, Daisuke Yasui, Shinji Ozaki Article Affiliation: Hideo Shigematsu Abstract: PURPOSE: This randomized phase II study was conducted to investigate the efficacy of cryotherapy in preventing peripheral neuropathy and dermatological adverse events in breast cancer patients treated with weekly paclitaxel. METHODS: Patients treated with 12 weekly doses of paclitaxel for breast cancer were randomized (1:1) into a cryotherapy or control group. The primary endpoint was the percentage of patients with a marked decrease in the Functional Assessment of Cancer Therapy-Neurotoxicity (FACT-NTX) score. The secondary endpoints were Patient Neurotoxicity Questionnaire (PNQ), Common Terminology Criteria for Adverse Event (CTCAE) for peripheral neuropathy, and FACT-Taxane score. RESULTS: Forty-four patients were randomly assigned to the cryotherapy (n = 22) or control groups (n = 22). The percentage of patients with a marked decrease in FACT-NTX scores was significantly lower in the cryotherapy group than in the control group (41 vs. 73%, p = 0.03). The incidence of CTCAE grade ≥ 2 sensory (p = 0.001) and motor peripheral neuropathy (p = 0.01), and PNQ grade D or higher for sensory peripheral neuropathy (p = 0.02), and decrease in the FACT-Taxane score (p = 0.02) were also significantly lower in the cryotherapy group than in the control group. There were no serious side effects associated with cryotherapy. CONCLUSION: Cryotherapy is an effective approach for prevention of peripheral neuropathy and dermatological adverse events in breast cancer patients treated with weekly paclitaxel. Article Published Date : Feb 07, 2020

Treatment of three hereditary leiomyomatosis patients with cryotherapy.

Abstract Title: Treatment of three hereditary leiomyomatosis patients with cryotherapy. Abstract Source: Dermatol Ther. 2020 Jan 9:e13226. Epub 2020 Jan 9. PMID: 31917494 Abstract Author(s): Belkız Uyar, Emine M Acar, Aslı Subaşıoğlu Article Affiliation: Belkız Uyar Abstract: Hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome is an autosomal dominant disorder characterized by cutaneous leiomyomas (CLM), uterine leiomyomas, and the increased risk of renal cell carcinoma. Piloleiomyomas develop from the arrectorpili muscle and are usually painful. For 22% of the affected patients, the pain is reported to impair their life quality. Since there are few case reports about cryotherapy for cutaneous leiomyomas in the literature, we have decided to present three patients who had painful cutaneous leiomyomas treated with cryotherapy. Article Published Date : Jan 08, 2020

Systematic review of oral cryotherapy for the management of oral mucositis in cancer patients and clinical practice guidelines.

Abstract Title: Systematic review of oral cryotherapy for the management of oral mucositis in cancer patients and clinical practice guidelines. Abstract Source: Support Care Cancer. 2019 Dec 14. Epub 2019 Dec 14. PMID: 31836937 Abstract Author(s): M Elvira P Correa, Karis Kin Fong Cheng, Karen Chiang, Abhishek Kandwal, Charles L Loprinzi, Takehiko Mori, Carin Potting, Tanya Rouleau, Juan J Toro, Vinisha Ranna, Anusha Vaddi, Douglas E Peterson, Paolo Bossi, Rajesh V Lalla, Sharon Elad Article Affiliation: M Elvira P Correa Abstract: PURPOSE: To update the 2013 Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) clinical practice guidelines on oral cryotherapy for the management of oral mucositis (OM) caused by cancer therapies. METHODS: A systematic review was conducted by the Mucositis Study Group of MASCC/ISOO. The evidence for each intervention for specific cancer treatment modalities was assigned a level of evidence (LoE). The findings were added to the database used to develop the 2013 MASCC/ISOO clinical practice guidelines. Based on the LoE, the guidelines were set as: recommendation, suggestion, or no guideline possible. RESULTS: A total of 114 papers were identified: 44 from PubMed and 70 from Web of Science. After abstract triage and merging with the 2013 database, 36 papers were reviewed. The LoE for prevention of OM with oral cryotherapy in patients undergoing autologous hematopoietic stem cell transplant using high-dose melphalan conditioning protocols was upgraded, and the guideline changed to recommendation. Additionally, the recommendation for prevention of OM with oral cryotherapy in patients receiving bolus 5-fluorouracil for the treatment of solid tumors was confirmed. No guidelines were possible for other clinical settings. CONCLUSIONS: The evidence supports recommendations for the use of oral cryotherapy for the prevention of OM for either (i) patients undergoing autologous hematopoietic stem cell transplant with high-dose melphalan conditioning protocols or (ii) patients receiving bolus 5-fluorouracil chemotherapy. Article Published Date : Dec 13, 2019

Effect of cryotherapy on dose of adjuvant paclitaxel in early-stage breast cancer.

Abstract Title: Effect of cryotherapy on dose of adjuvant paclitaxel in early-stage breast cancer. Abstract Source: Support Care Cancer. 2019 Dec 11. Epub 2019 Dec 11. PMID: 31828491 Abstract Author(s): F Rosenbaek, H S Holm, J V B Hjelmborg, M Ewertz, Jeanette Dupont Jensen Article Affiliation: F Rosenbaek Abstract: BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting toxicity of paclitaxel. Though no pharmacological agents have been identified to prevent CIPN, cryotherapy with frozen gloves and socks may reduce the risk of developing CIPN and thereby increase the likelihood of patients completing the planned dose of paclitaxel. PATIENTS AND METHODS: Among women with early-stage breast cancer who received at least one cycle of paclitaxel, 119 were included in the 2016 cohort who received cryotherapy when they developed symptoms of CIPN, and 96 patients in the 2017 cohort who received prophylactic cryotherapy. From electronic patient records, data were abstracted on dates and doses of adjuvant paclitaxel, dose reductions, cycle delays, symptoms of CIPN, and whether and when frozen gloves and socks were used. The outcome was the proportion of patients completing the planned 720 mg/mof paclitaxel cumulated over nine cycles. The hazard ratio (HR) of a dose-limiting event due to CIPN was estimated in a Cox proportional hazards model. RESULTS: In the 2016 cohort, cryotherapy was needed due to symptoms of CIPN in 54 (45%) patients. Significantly, more patients, 77% in the 2017 cohort, completed the planned dose of 720 mg/m² compared with 64% in the 2016 cohort, p = 0.017. The HR of a dose reduction or cessation due to CIPN, adjusted for age and HER-2 status, was 0.50 (95% confidence interval 0.30-0.84), p = 0.009, for the 2017 cohort compared with the 2016 cohort. CONCLUSIONS: The results of this study suggest that prophylactic cryotherapy may reduce the risk of a dose-limiting event due to CIPN and increase the proportion of patients completing the planned dose of paclitaxel in adjuvant treatment of early-stage breast cancer. Despite this, CIPN remains to be an important dose-limiting toxicity of paclitaxel. Article Published Date : Dec 10, 2019

Randomized controlled trial of cryotherapy to prevent paclitaxel-induced peripheral neuropathy (RU221511I); an ACCRU trial.

Abstract Title: Randomized controlled trial of cryotherapy to prevent paclitaxel-induced peripheral neuropathy (RU221511I); an ACCRU trial. Abstract Source: Breast. 2019 Dec ;48:89-97. Epub 2019 Sep 19. PMID: 31590108 Abstract Author(s): Kathryn J Ruddy, Jennifer Le-Rademacher, Mario E Lacouture, Mary Wilkinson, Adedayo A Onitilo, Amy C Vander Woude, Maria T Grosse-Perdekamp, Travis Dockter, Angelina D Tan, Andreas Beutler, Charles L Loprinzi Article Affiliation: Kathryn J Ruddy Abstract: PURPOSE: This pilot trial aimed to assess if cooling hands and feet with crushed ice during receipt of paclitaxel helps prevent peripheral neuropathy. METHODS: This prospective, randomized trial compared cryotherapy to standard care in patients initiating paclitaxel weekly x 12. For those on cryotherapy, hands and feet were cooled starting 15 min prior to and ending 15 min after each paclitaxel dose. EORTC QLQ-CIPN20 was completed at baseline, weekly x12, then monthly x6. Area under the curve (AUC) was calculated for subscale scores, adjusting for baseline, and compared between arms (Wilcoxon rank-sum test). Cross-study comparisonsused data from 2 prior similarly-conducted neuropathy trials. RESULTS: Forty-six patients were accrued. Three withdrew and one was ineligible. Of the remaining 42 (21 cryotherapy, 21 control), 39 (19 cryotherapy, 20 control) were analyzable for AUC. Cryotherapy was well tolerated, but the AUC of the CIPN20 sensory scores over 12 weeks of paclitaxel was not found to differ between the study arms (mean difference 3.45, 95% CI -3.13 to 10.02, p = 0.26). However, the control arm of the current trial experienced less neuropathy than did the placebo arms of two previous similar trials. When our cryotherapy arm was compared to the combined control arms from all three trials, the cryotherapy arm had less neuropathy (Wilcoxon Rank-Sum p = 0.01). CONCLUSION: While there was no difference in CIPN20 scores identified between the 2 study arms in the current phase II trial, further investigation is needed given that the control arm experienced less neuropathy than was expected. Article Published Date : Nov 30, 2019
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