Abstract 151P
Background
Chemotherapy induced peripheral neuropathy (CIPN) is a common side effect of many chemotherapy drugs and has a profound impact on quality of life. CIPN due to paclitaxel is a common dose-limiting toxicity which can adversely affect treatment results by forcing dose reduction and sometimes premature treatment discontinuation.
Methods
This is a prospective self-control study that included 30 female patients with early breast cancer who underwent breast conservative surgery (BCS) or modified radical mastectomy (MRM) and were going to receive adjuvant chemotherapy including weekly paclitaxel for 12 cycles. Study patients were allowed to use hypothermic gloves on one hand for 15min before, during, and after administration of intravenous weekly paclitaxel using the other hand as a control. Sensory and motor nerve conduction studies for both upper limbs were done before beginning and after end of adjuvant paclitaxel. Studied parameters were sensory nerve action potential (SNAP) amplitude and sensory conduction velocity (SCV) of ulnar and superficial radial nerves together with compound muscle action potential (CMAP) amplitude, motor conduction velocity (MCV) and distal latency (DL) of ulnar nerves.
Results
Patients had a mean age of 46.40 ± 10.45 and a median of 44 years. A mean body mass index of 27.39 ± 4.58 and median of 26.50. 76.7% and 23.3% were premenopausal and postmenopausal, 66.7% and 33.3% had MRM and BCS, respectively. Stage II and III represented 73.3% and 33.3%, respectively. In the post chemotherapy evaluation there was a statistically significant difference between hypothermic and control arms as regards ulnar and superficial radial SNAP amplitude, ulnar CMAP amplitude and ulnar motor DL (p value 0.005, 0.043, 0.001, and 0.008, respectively) but no difference regarding SCV in ulnar and radial nerves. In contrast, the pre chemotherapy evaluation showed no statistically significant difference between both arms in any of the studied parameters.
Conclusions
Limb hypothermia had a potential protective effect against paclitaxel induced peripheral neuropathy in both sensory and motor fibers, indicating that it could be a promising solution in decreasing CIPN.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Faculty of Medicine, University of Alexandria.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.