Regional limb cooling for the prevention of chemotherapy-induced toxicities: a narrative review
Teja Mallela, Lily Kaufman, Brittany Dulmage
Abstract
PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN), hand-foot syndrome (HFS), and nail changes are common adverse effects associated with chemotherapy, significantly impacting the quality of life of cancer patients, and effective interventions remain an unmet need in oncologic care. Regional limb cooling is an emerging non-pharmacological approach used to prevent or reduce the severity of these adverse side effects. Although the awareness of regional limb cooling is rather prevalent, the overall use and efficacy of this non-pharmacological therapy in preventing chemotoxicities is not universally agreed upon. This paper reviews the current evidence regarding the use, efficacy, limitations, and safety of regional limb cooling in preventing or reducing CIPN, HFS, and nail changes in clinical settings. METHODS: A literature review was conducted using the PubMed database to identify the most recent English articles published between 2004 and 2024 regarding the use of regional limb cooling to prevent CIPN, HFS, and nail changes. RESULTS: Based on the reviewed studies, regional limb cooling can potentially be a low-risk, non-pharmacological intervention that can prevent and reduce common and debilitating chemotherapy-induced toxicities. Although the studies described in this paper demonstrate encouraging results, there is still notable variability in efficacy. CONCLUSION: This underscores the need for randomized controlled trials, device innovation, and standardized protocols in regional limb cooling to properly demonstrate its potential for alleviating these common, debilitating conditions and enabling patients to adhere to their chemotherapy regimens more comfortably. This would thereby enhance overall cancer treatment tolerability and lead to safer, more patient-centered chemotherapy management.