Single-center prospective trial of prevention of taxane-induced nail changes and peripheral neuropathy by extremity cooling

Nail toxicity and chemotherapy-induced peripheral neuropathy (CIPN) are common side effects of taxane chemotherapy. A single-center prospective trial at Kantonsspittal Graubünden (Chur, Switzerland) evaluated cooling of the extremities by the Hilotherapy machine for prevention of these side effects. Patients receiving docetaxel (planned dose ≥ 300 mg/m²) or paclitaxel (planned dose ≥ 700 mg/m²) in the adjuvant or palliative setting of different cancers were included. From 30 minutes before to 30 minutes after chemotherapy infusion,the dominant hand and foot were cooled to approximately 10 ^oC, while the contralateral hand and foot were used as intrapatient comparison. Cooling resulted in lower risk of nail toxicity due to docetaxel (OR 0.42; p=0.045) and in lower risk of CIPN due to paclitaxel (OR 0.28; p=0.001). Cooling was well tolerated. The authors conclude that cooling of hands and feet has a clinically meaningful impact on reducing occurrence of chemotherapy-induced nailtoxicity and peripheral neuropathy.