國家衛生研究院 NHRI:Item 3990099045/10226
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    题名: Limb hypothermia for preventing paclitaxel-induced peripheral neuropathy in breast cancer patients: A pilot study
    作者: Sundar, R;Bandla, A;Tan, SS;Liao, LD;Kumarakulasinghe, NB;Jeyasekharan, AD;Ow, SG;Ho, J;Tan, DS;Lim, JS;Vijayan, J;Therimadasamy, AK;Hairom, Z;Ang, E;Ang, S;Thakor, NV;Lee, SC;Wilder-Smith, EP
    贡献者: Institute of Biomedical Engineering and Nanomedicine
    摘要: BACKGROUND: Peripheral neuropathy (PN) due to paclitaxel is a common dose-limiting toxicity with no effective prevention or treatment. We hypothesize that continuous-flow limb hypothermia can reduce paclitaxel-induced PN. PATIENTS AND METHODS: An internally controlled pilot trial was conducted to investigate the neuroprotective effect of continuous-flow limb hypothermia in breast cancer patients receiving weekly paclitaxel. Patients underwent limb hypothermia of one limb for a duration of 3 h with every paclitaxel infusion, with the contralateral limb used as control. PN was primarily assessed using nerve conduction studies (NCSs) before the start of chemotherapy, and after 1, 3, and 6 months. Skin temperature and tolerability to hypothermia were monitored using validated scores. RESULTS: Twenty patients underwent a total of 218 cycles of continuous-flow limb hypothermia at a coolant temperature of 22 degrees C. Continuous-flow limb hypothermia achieved mean skin temperature reduction of 1.5 +/- 0.7 degrees C and was well tolerated, with no premature termination of cooling due to intolerance. Grade 3 PN occurred in 2 patients (10%), grade 2 in 2 (10%), and grade 1 in 12 (60%). Significant correlation was observed between amount of skin cooling and motor nerve amplitude preservation at 6 months (p < 0.0005). Sensory velocity and amplitude in the cooled limbs were less preserved than in the control limbs, but the difference did not attain statistical significance. One patient with a history of diabetes mellitus had significant preservation of compound muscle action potential in the cooled limb on NCS analysis. CONCLUSION: This study suggests that continuous limb hypothermia accompanying paclitaxel infusion may reduce paclitaxel-induced PN and have therapeutic potential in select patients and warrants further investigation. The method is safe and well tolerated.
    日期: 2017-01-10
    關聯: Frontiers in Oncology. 2017 Jan 10;6:Article number 274.
    Link to: http://dx.doi.org/10.3389/fonc.2016.00274
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=2234-943X&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000391642800001
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85012195584
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