Cryotherapy for Prevention of Taxane-Induced Peripheral Neuropathy: A Meta-Analysis
PurposeTaxanes are widely used in gynecological cancer therapy, however, taxane-induced peripheral neuropathy (TIPN) limits chemotherapy dose and reduces patients’ quality of life. As a safe and convenient intervention, cryotherapy has been recommended as a promising intervention in the recent clini...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.781812/full |
| _version_ | 1828975519366905856 |
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| author | Junting Jia Yimeng Guo Raghav Sundar Raghav Sundar Raghav Sundar Raghav Sundar Aishwarya Bandla Aishwarya Bandla Zhiying Hao |
| author_facet | Junting Jia Yimeng Guo Raghav Sundar Raghav Sundar Raghav Sundar Raghav Sundar Aishwarya Bandla Aishwarya Bandla Zhiying Hao |
| author_sort | Junting Jia |
| collection | DOAJ |
| description | PurposeTaxanes are widely used in gynecological cancer therapy, however, taxane-induced peripheral neuropathy (TIPN) limits chemotherapy dose and reduces patients’ quality of life. As a safe and convenient intervention, cryotherapy has been recommended as a promising intervention in the recent clinical guidelines for the prevention of TIPN. Although there are a considerable number of studies which explored the use of cryotherapy in preventing chemotherapy-induced peripheral neuropathy (CIPN), there is insufficient large-scale clinical evidence. We performed a meta-analysis on the current available evidence to examine whether cryotherapy can prevent TIPN in cancer patients receiving taxanes.MethodsWe searched databases including PubMed, Embase, and Cochrane from inception to August 3, 2021 for eligible trials. Clinical trials that examined the efficacy of cryotherapy for prevention of TIPN were included. The primary outcome was the incidence of TIPN, and secondary outcomes were incidence of taxane dose reduction and changes in nerve conduction studies. The meta-analysis software (RevMan 5.3) was used to analyze the data.ResultsWe analyzed 2250 patients from 9 trials. Assessments using the Common Terminology Criteria for Adverse Events (CTCAE) score showed that cryotherapy could significantly reduce the incidence of motor and sensory neuropathy of grade≥2 (sensory: RR 0.65, 95%CI 0.56 to 0.75, p<0.00001; motor: RR 0.18, 95% CI [0.03, 0.94], p=0.04). When evaluated using the Patient Neuropathy Questionnaire (PNQ), cryotherapy demonstrated significant reduction in the incidence of sensory neuropathy (RR 0.11, 95% CI 0.04 to 0.31], p<0.0001), but did not show significant reduction in the incidence of motor neuropathy (RR 0.46, 95% CI 0.11 to 1.88, p=0.28). Cryotherapy was associated with reduced incidences of taxane dose reduction due to TIPN (RR 0.48, 95% CI [0.24, 0.95], p=0.04) and had potential to preserve motor nerves.ConclusionsCryotherapy is likely to prevent TIPN in patients receiving taxanes. High quality and sufficient amount of evidence is warranted. |
| first_indexed | 2024-12-14T14:21:23Z |
| format | Article |
| id | doaj.art-e6b3033b72f9472d89be439157e9c8d1 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-14T14:21:23Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-e6b3033b72f9472d89be439157e9c8d12022-12-21T22:58:04ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-11-011110.3389/fonc.2021.781812781812Cryotherapy for Prevention of Taxane-Induced Peripheral Neuropathy: A Meta-AnalysisJunting Jia0Yimeng Guo1Raghav Sundar2Raghav Sundar3Raghav Sundar4Raghav Sundar5Aishwarya Bandla6Aishwarya Bandla7Zhiying Hao8Department of Pharmacy, the Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, ChinaDepartment of Pharmacy, the Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, ChinaDepartment of Haematology-Oncology, National University Cancer Institute, National University Hospital, Singapore, SingaporeThe N.1 Institute for Health, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeCancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore, SingaporeThe N.1 Institute for Health, National University of Singapore, Singapore, SingaporeNational University Cancer Institute, National University Hospital, Singapore, SingaporeDepartment of Pharmacy, the Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, ChinaPurposeTaxanes are widely used in gynecological cancer therapy, however, taxane-induced peripheral neuropathy (TIPN) limits chemotherapy dose and reduces patients’ quality of life. As a safe and convenient intervention, cryotherapy has been recommended as a promising intervention in the recent clinical guidelines for the prevention of TIPN. Although there are a considerable number of studies which explored the use of cryotherapy in preventing chemotherapy-induced peripheral neuropathy (CIPN), there is insufficient large-scale clinical evidence. We performed a meta-analysis on the current available evidence to examine whether cryotherapy can prevent TIPN in cancer patients receiving taxanes.MethodsWe searched databases including PubMed, Embase, and Cochrane from inception to August 3, 2021 for eligible trials. Clinical trials that examined the efficacy of cryotherapy for prevention of TIPN were included. The primary outcome was the incidence of TIPN, and secondary outcomes were incidence of taxane dose reduction and changes in nerve conduction studies. The meta-analysis software (RevMan 5.3) was used to analyze the data.ResultsWe analyzed 2250 patients from 9 trials. Assessments using the Common Terminology Criteria for Adverse Events (CTCAE) score showed that cryotherapy could significantly reduce the incidence of motor and sensory neuropathy of grade≥2 (sensory: RR 0.65, 95%CI 0.56 to 0.75, p<0.00001; motor: RR 0.18, 95% CI [0.03, 0.94], p=0.04). When evaluated using the Patient Neuropathy Questionnaire (PNQ), cryotherapy demonstrated significant reduction in the incidence of sensory neuropathy (RR 0.11, 95% CI 0.04 to 0.31], p<0.0001), but did not show significant reduction in the incidence of motor neuropathy (RR 0.46, 95% CI 0.11 to 1.88, p=0.28). Cryotherapy was associated with reduced incidences of taxane dose reduction due to TIPN (RR 0.48, 95% CI [0.24, 0.95], p=0.04) and had potential to preserve motor nerves.ConclusionsCryotherapy is likely to prevent TIPN in patients receiving taxanes. High quality and sufficient amount of evidence is warranted.https://www.frontiersin.org/articles/10.3389/fonc.2021.781812/fullcryotherapypreventiontaxaneperipheral neuropathymeta-analysis |
| spellingShingle | Junting Jia Yimeng Guo Raghav Sundar Raghav Sundar Raghav Sundar Raghav Sundar Aishwarya Bandla Aishwarya Bandla Zhiying Hao Cryotherapy for Prevention of Taxane-Induced Peripheral Neuropathy: A Meta-Analysis Frontiers in Oncology cryotherapy prevention taxane peripheral neuropathy meta-analysis |
| title | Cryotherapy for Prevention of Taxane-Induced Peripheral Neuropathy: A Meta-Analysis |
| title_full | Cryotherapy for Prevention of Taxane-Induced Peripheral Neuropathy: A Meta-Analysis |
| title_fullStr | Cryotherapy for Prevention of Taxane-Induced Peripheral Neuropathy: A Meta-Analysis |
| title_full_unstemmed | Cryotherapy for Prevention of Taxane-Induced Peripheral Neuropathy: A Meta-Analysis |
| title_short | Cryotherapy for Prevention of Taxane-Induced Peripheral Neuropathy: A Meta-Analysis |
| title_sort | cryotherapy for prevention of taxane induced peripheral neuropathy a meta analysis |
| topic | cryotherapy prevention taxane peripheral neuropathy meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.781812/full |
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