1. Introduction
oxaliplatin-induced, breast cancer, CIPN, neurotoxic, Cancer
SIDE EFFECT, BREAST CANCER, ADVERSE EVENT, CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY, CANCER
Chemotherapy-induced peripheral neuropathy (CIPN) is a serious side effect of weekly paclitaxel-based chemotherapy for breast cancer, that can persist for years. Cryotherapy therapy is effective for preventing early CIPN, but its protective effect on persistent CIPN is uncertain. This is a cross-sectional study conducted as an ancillary analysis of a randomized trial investigating the preventive effect of cryotherapy on CIPN in breast cancer patients receiving weekly paclitaxel-based chemotherapy (UMIN000034966). Eligible patients were evaluated for CIPN at more than a year after completion of the chemotherapy (persistent CIPN). CIPN was defined as a 6 or more points reduction from baseline in the Functional Assessment of Cancer Therapy-Neurotoxicity (FACT-NTX) score. The incidence of early and persistent CIPN was compared between cryotherapy and control groups. Thirty-eight patients were examined for both early and persistent CIPN. The median time from completion of the weekly paclitaxel-based chemotherapy to the questionnaire for persistent CIPN was 2.3 (1.3–3.1) years. In all 38 patients, persistent CIPN was demonstrated in 10 (26.3%), respectively. There was a numerical, however not significant, reduction in the incidence of persistent CIPN (15.8% vs 36.8%, Chemotherapy-induced peripheral neuropathy (CIPN) is a serious adverse event that significantly deteriorates the quality of life and survivorship.For patients with paclitaxel-induced persistent CIPN, there is weak evidence for treatment to relieve the symptoms. Duloxetine is the only recommended treatment for symptomatic CIPN, however, duloxetine may be less effective for taxane-induced than oxaliplatin-induced CIPN.Compared with the treatment of persistent CIPN, physical therapy, prevention of CIPN with cryotherapy, compression therapy and exercise may be more effective modalities in patients receiving neurotoxic chemotherapy. Cryotherapy and compression therapy are thought to prevent acute CIPN by reducing paclitaxel exposure in fingertip and toes through their analogous mechanism of compression or vasoconstriction.The study aims to assess the preventive effect of cryotherapy on persistent CIPN at more than 1 year after completing weekly paclitaxel-based chemotherapy. We conducted a cross-sectional study as an ancillary analysis of the previous trial that assessed the preventive effect of cryotherapy on paclitaxel-induced early CIPN in breast cancer patients (UMIN000034966).