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Johnson K, Stoffel B, Schwitter M, Hayoz S, Rojas Mora A, Fischer Maranta A, El Saadany T, Hasler U, von Moos R, Patzen A, Mark M, Roberts G, Cathomas R. Prevention of taxane chemotherapy-induced nail changes and peripheral neuropathy by application of extremity cooling: a prospective single-centre study with intrapatient comparison. Support Care Cancer 2024; 32:554. [PMID: 39066890 PMCID: PMC11283420 DOI: 10.1007/s00520-024-08737-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 07/12/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE Common side effects of taxane chemotherapy are nail toxicity and peripheral neuropathy (CIPN) causing severe impact on the quality of life. Different methods of cryotherapy to prevent these side effects have been tested. We investigated the use of machine-controlled cooling of hands and feet to reduce nail toxicity and CIPN in patients receiving taxane chemotherapy. METHODS Patients receiving Docetaxel (planned dose ≥ 300 mg/m2) or Paclitaxel (planned dose ≥ 720 mg/m2 - ) in the adjuvant or palliative setting of different cancers were included. The dominant hand and foot were cooled to approximately 10 °C using the Hilotherapy machine. The contralateral hand and foot were used as intrapatient comparison. The primary endpoint was the occurrence of any CIPN due to paclitaxel or nail toxicity due to Docetaxel. Both the intention to treat population (ITT) and the per protocol population (PPP) were analyzed. RESULTS A total of 69 patients, 21 treated with Docetaxel and 48 with Paclitaxel, were included at our centre between 08/2020 and 08/2022. Nail toxicity due to Docetaxel was overall not significantly improved by cooling in the ITT or PPP but a significant benefit across visits was found for the ITT. CIPN due to Paclitaxel was numerically better in the ITT and significantly better in the PPP. A significant benefit of cooling on CIPN occurrence across visits was found for the ITT and the PPP. Cooling was very well tolerated. CONCLUSION Cooling of hands and feet has a clinically meaningful impact on reducing occurrence of CIPN and nail toxicity on treatment with taxanes. Effects are more significant over time and are dose dependent. TRIAL REGISTRATION NUMBER 2020-00381. Date of registration. 24th February 2020.
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Affiliation(s)
- Kristen Johnson
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
- Department of Internal Medicine, Kantonsspital Graubünden, Chur, Switzerland
| | - Barbara Stoffel
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Michael Schwitter
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | | | | | | | - Tämer El Saadany
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Ursula Hasler
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Roger von Moos
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Annalea Patzen
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Michael Mark
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Gillian Roberts
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Richard Cathomas
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland.
- University of Zürich, Zurich, Switzerland.
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Ajdari M, Ranjbar A, Karimian K, Karimi M, Heli H, Sattarahmady N. Characterization and Evaluation of Nano-niosomes Encapsulating Docetaxel against Human Breast, Pancreatic, and Pulmonary Adenocarcinoma Cancer Cell Lines. J Biomed Phys Eng 2024; 14:159-168. [PMID: 38628892 PMCID: PMC11016824 DOI: 10.31661/jbpe.v0i0.2401-1708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 02/29/2024] [Indexed: 04/19/2024]
Abstract
Background Docetaxel (DXL) is an antineoplastic agent for cancer treatment, the therapeutic efficiency of which is limited due to low solubility, hydrophobicity, and tissue specificity. Objective In this study, nano-niosomes were introduced for improving therapeutic index of DXL. Material and Methods In this experimental study, two nano-niosomes were synthesized using Span 20® and Span 80® and a thin film hydration method with DXL loading (DXL-Span20 and DXL-Span80). Characterization, in-vitro cytotoxicity and bioavailability of the nano-niosomes was also evaluated via in-vivo experiments. Results DXL-Span20 and DXL-Span80 have vesicles size in a range of 84-90 nm and negative zeta potentials. DXL entrapment efficiencies were obtained as 69.6 and 74.0% for DXL-Span20 and DXL-Span80, respectively; with an in-vitro sustained release patterns. Cytotoxicity assays were performed against MDA-MB-231, Calu-6, and AsPC-1 cell lines, and the results indicated that DXL loading into nano-niosomes led to decrement in values of half-maximal inhibitory concentration (IC50) at least 2.5 times and at most 6.5 times, compared to free DXL. Moreover, the rat blood bioavailability of DXL after intraperitoneal administration and the pharmacokinetic parameters indicated higher DXL plasma level and the higher effectiveness of DXL-Span80 compared to DXL-Span20. Conclusion Carrying DXL by the nano-niosomes led to enhanced cytotoxicity (and lower IC50 values) and higher efficacy with enhanced pharmacokinetic parameters.
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Affiliation(s)
- Mohammadreza Ajdari
- Nanomedicine and Nanobiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aliyeh Ranjbar
- Nanomedicine and Nanobiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khashayar Karimian
- Arasto Pharmaceutical Chemicals Inc., Yousefabad, Jahanarar Avenue, Tehran, Iran
| | - Maryam Karimi
- Nanomedicine and Nanobiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Heli
- Nanomedicine and Nanobiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naghmeh Sattarahmady
- Nanomedicine and Nanobiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Medical Physics and Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Mazzega-Fabbro C, Polesel J, Spazzapan S, Meneghetti L, Montagner D, Tabaro G, Bartoletti M, Puglisi F. Mild cryotherapy for prevention of paclitaxel-induced nail toxicity in breast cancer patients: A phase II single-arm clinical trial. Clin Breast Cancer 2023; 23:447-453. [PMID: 36997403 DOI: 10.1016/j.clbc.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/23/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Nail changes are among the most common dermatological adverse events in paclitaxel-receiving patients. Although effective, low-temperature prophylactic cryotherapy is discomforting and a potential cause of side effects, resulting in low patients' adherence. PATIENTS AND METHODS A phase II single-arm study evaluating mild cryotherapy for the reduction of 12-week, grade 2 nail toxicity was conducted on 67 taxane-naïve breast cancer patients (age 18-74 years) undergoing weekly adjuvant chemotherapy with paclitaxel. Instant-ice packs were fixed over the fingers and toes for a total of 70 minutes during paclitaxel infusion at a temperature between -5 °C and +5 °C. Nail toxicity was evaluated weekly (CTCAE vs 4.03), including grade 2 (ie, onycholysis, subungual hematoma, onychomadesis) and grade 1 nail toxicities. RESULTS Twelve patients experienced grade 2 nail toxicities (17.9%, 95% confidence interval [CI] 9.6%-29.2%; median time to onset: 56 days): onycholysis was the most frequent grade 2 toxicity (13.4%), followed by subungual hematoma (9.0%) and onychomadesis (1.5%). Grade 1 toxicity occurred in 33 patients (63.5%, 95% CI 49.0%-76.4%) with nail discoloration representing by far the most frequent toxicity (59.6%). Seventeen patients (25.4%) reported no nail toxicity. 62.7% of patients reported no pain and 22.4% suffered moderate pain. No patient experienced severe pain or others adverse effects. CONCLUSIONS Instant-ice pack is a feasible prophylactic intervention for nail toxicity, well tolerated by patients and with limited impact on routine workload. It could be considered for patients refusing (or interrupting) cryotherapy, and it can be implemented when frozen gloves management is not feasible.
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Emvalomati A, Oflidou V, Papageorgiou C, Kemanetzi C, Giannouli M, Kalloniati E, Efthymiadis K, Koukoutzeli C, Timotheadou E, Trigoni A, Patsatsi A, Lazaridou E, Apalla Z, Trakatelli M. Narrative Review of Drug-Associated Nail Toxicities in Oncologic Patients. Dermatol Pract Concept 2023; 13:dpc.1301a64. [PMID: 36892360 PMCID: PMC9946059 DOI: 10.5826/dpc.1301a64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Nail toxicity represents one of the most common cutaneous adverse effects of both classic chemotherapeutic agents and new oncologic drugs, including targeted treatments and immunotherapy. OBJECTIVES We aimed to provide a comprehensive literature review of nail toxicities derived from conventional chemotherapeutic agents, targeted therapies (EGFR inhibitors, multikinase inhibitors, BRAF and MEK inhibitors) and immune checkpoint inhibitors (ICIs), including clinical presentation, implicated drugs and approaches for prevention and management. METHODS Retrieved literature from PubMed registry database was reviewed to include all articles published up to May 2021 relevant to the clinical presentation, diagnosis, incidence, prevention, and treatment of oncologic treatment-induced nail toxicity. The internet was searched for relevant studies. RESULTS A wide spectrum of nail toxicities is associated with both, conventional and newer anticancer agents. The frequency of nail involvement, especially with immunotherapy and new targeted agents remains unknown and patients with different cancer types receiving different regimens may develop the same nail disorder, whereas patients with the same type of cancer under the same chemotherapeutic treatment may develop different types of nail alterations. The underlying mechanisms of the varying individual susceptibility and the diverse nail responses to various anticancer treatments need further investigation. CONCLUSION Early recognition and treatment of nail toxicities can minimize their impact, allowing better adherence to conventional and newer oncologic treatments. Dermatologists, oncologists and other implicated physicians should be aware of these burdensome adverse effects in order to guide management and prevent impairment of patients' quality of life.
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Affiliation(s)
- Anastasia Emvalomati
- Second Department of Dermatology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Valentina Oflidou
- Second Department of Dermatology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Chryssoula Papageorgiou
- Second Department of Dermatology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Christina Kemanetzi
- Second Department of Dermatology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Maria Giannouli
- Second Department of Dermatology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Evangelia Kalloniati
- Second Department of Dermatology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Konstantinos Efthymiadis
- Department of Medical Oncology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Chrysanthi Koukoutzeli
- Department of Medical Oncology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Eleni Timotheadou
- Department of Medical Oncology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Anastasia Trigoni
- Second Department of Dermatology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Aikaterini Patsatsi
- Second Department of Dermatology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Elizabeth Lazaridou
- Second Department of Dermatology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Zoe Apalla
- Second Department of Dermatology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Myrto Trakatelli
- Second Department of Dermatology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
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5
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Morrison A, Marshall-McKenna R, McFadyen AK, Hutchison C, Rice AM, Stirling L, McIlroy P, Macpherson IR. A randomised controlled trial of interventions for taxane-induced nail toxicity in women with early breast cancer. Sci Rep 2022; 12:11575. [PMID: 35798751 PMCID: PMC9262963 DOI: 10.1038/s41598-022-13327-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 05/06/2022] [Indexed: 11/17/2022] Open
Abstract
Onycholysis and paronychia has been associated with chemotherapy treatment for women with breast cancer. Our primary aim was to investigate the effectiveness of different topical interventions to ameliorate nail toxicity. Secondary aims were to explore the full range and severity of possible nail changes associated with taxane-based chemotherapy and the specific impact this had on quality of life, using two novel measures. This was an exploratory randomised controlled trial of three topical interventions (standard care, nail polish or specialist nail drops) for the prevention or reduction of nail changes induced by taxane-based chemotherapy. Outcomes included nail toxicity assessed at three time points (baseline, 3 weeks and 3 months post completion of chemotherapy) using two novel clinical tools (NToX-G12, NToX-QoL) and the Common Terminology Criteria for Adverse Events (CTCAE v3) and EQ-5D-5L. A total of 105 women were recruited (35 in each arm) and monitored up to three months post completion of chemotherapy. Almost 20% of patients were over the age of 60 years. There were 26 withdrawals, the majority from the nail polish arm. Residual Maximum Likelihood REML analysis indicated a significant arm, time and interaction effect for each intervention (p < 0.001). Less nail toxicity was observed in patients receiving specialist nail drops or standard care arms in comparison to those using nail polish. This study provides evidence to support clinicians’ suggestions on nail care recommendations based on the patients’ needs and preferences. Future investigations into comparing or combining cryotherapy and topical solutions that can support patient’s decisions are warranted.
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Affiliation(s)
- Audrey Morrison
- The Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, G12 0YN, Scotland.
| | | | | | - Cathy Hutchison
- The Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, G12 0YN, Scotland
| | - Ann-Marie Rice
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, G12 8QQ, Scotland
| | - Lynne Stirling
- The Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, G12 0YN, Scotland
| | - Pauline McIlroy
- The Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, G12 0YN, Scotland
| | - Iain R Macpherson
- The Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, G12 0YN, Scotland.,Institute of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Glasgow, G61 1QH, UK
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6
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Coolbrandt A, Vancoille K, Dejaeger E, Peeters H, Laenen A, Neven P, Punie K, Wildiers H. Preventing taxane-related peripheral neuropathy, pain and nail toxicity: a prospective self-controlled trial comparing hilotherapy with frozen gloves in early breast cancer. Breast Cancer Res Treat 2022; 192:293-301. [PMID: 34982322 DOI: 10.1007/s10549-021-06477-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/02/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE The prevention of taxane-related toxicities at the extremities is highly important for patients' treatment and quality-of-life. Several studies endorse hand/foot-cooling using frozen gloves as a prophylactic intervention. Unlike frozen gloves, hilotherapy produces cooling at a constant temperature. Comparative data with frozen gloves are unavailable. METHODS This prospective self-controlled study explores the efficacy of hilotherapy at the right hand and foot compared to frozen gloves at the left in patients with early breast cancer treated with weekly paclitaxel 80 mg/m2 or three-weekly docetaxel 75 mg/m2. Patient-reported outcomes were collected at baseline, 6, 12, 18 and 24 weeks after the start of treatment. Primary and secondary endpoints were the incidence of any-grade and ≥ grade 2 side-effects (peripheral neuropathy, pain and nail toxicities), and perceived comfort of both interventions. RESULTS Sixty-two patients participated. The incidence of any-grade side-effects was similar on both sides, 85.5% with hilotherapy and 90.3% with frozen gloves (p = 1.000). The incidence of ≥ grade 2 side-effects at the extremities was significantly lower with hilotherapy: 43.6% compared to 61.3% with frozen gloves (p = 0.013). Perceived comfort was significantly better for hilotherapy than for frozen gloves (p < 0.0001). CONCLUSIONS Compared to frozen gloves, continuous cooling of hands and feet using hilotherapy produces better prevention of ≥ grade 2 patient-reported side-effects at the extremities (peripheral neuropathy, pain and nail toxicities). Perceived comfort was significantly better for hilotherapy. From a clinical and patient perspective, hilotherapy is a better alternative for preventing clinically significant taxane-related side-effects.
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Affiliation(s)
- Annemarie Coolbrandt
- Department of Oncology Nursing, University Hospitals Leuven, Herestraat 49, Leuven, Belgium. .,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
| | - K Vancoille
- Department of Oncology Nursing, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - E Dejaeger
- Department of Oncology Nursing, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - H Peeters
- Department of Oncology Nursing, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - A Laenen
- Interuniversity Centre for Biostatistics and Statistical Bioinformatics, KU Leuven, Leuven, Belgium
| | - P Neven
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - K Punie
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - H Wildiers
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
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7
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Şimşek NY, Demir A. Cold Application and Exercise on Development of Peripheral Neuropathy during Taxane Chemotherapy in Breast Cancer Patients: A Randomized Controlled Trial. Asia Pac J Oncol Nurs 2021; 8:255-266. [PMID: 33850959 PMCID: PMC8030600 DOI: 10.4103/apjon.apjon-2075] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/08/2020] [Indexed: 12/24/2022] Open
Abstract
Objective Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer treatment. There is no proven pharmacological application to prevent CIPN. This study was conducted to compare the effects of cold application and exercise on peripheral neuropathy development in patients with breast cancer who received taxane. Methods This was a multicenter clinical trial. The study was conducted as a randomized controlled trial on breast cancer patients who had chemotherapy-induced peripheral neuropathy complaints between July 2017 and January 2018 in an outpatient chemotherapy unit of training-research and a university hospital. A standardized, home-based, 12-week exercise program involved progressive strengthening, stretching, and balance exercises. Cold packs were applied for the duration of all 12 taxane infusions and then continued at home. The standard care protocol (information about side effects) of the clinic was used for patients in the control group. Data were collected via Patient Identification Form and CIPN Assessment Tool. Demographic data were evaluated by number and percentage ratios, and the study groups' mean scores were compared by Kruskal-Wallis and Wilcoxon analyses. The data were collected at two time points including baseline (T1) and week 12 (T2). Results The study was completed with a total of 90 patients, so that each of the study groups, exercise, cold application, and control groups, included 30 patients. The mean of pre- and posttest results in the cold applied group revealed an increase in hand numbness, weakness, and distress (P < 0.05). However, no significant difference existed between the means of the pre- and the posttests in the exercise group (P = 0.79-0.1). The mean scores of all the symptoms in the control group except the loss of balance increased significantly (P < 0.05). Exercise reduced CIPN symptoms of numbness in hands (P = 0.009) and in the feet (P = 0.005) significantly compared to the cold application and control. Conclusions It was found that exercise was more effective than cold application in the management of CIPN.
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Affiliation(s)
| | - Ayten Demir
- Department of Nursing, Faculty of Health Sciences, Ankara University, Ankara, Turkey
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8
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Alshari O, Aleshawi A, Al Sharie AH, Msameh A, Al-Omari I, Msameh R, Almegdadi A, Albals D. The Effect of Nail Lacquer on Taxane-Induced Nail Changes in Women With Breast Cancer. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2020; 14:1178223420929702. [PMID: 32595274 PMCID: PMC7297473 DOI: 10.1177/1178223420929702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/05/2020] [Indexed: 12/24/2022]
Abstract
Objective Taxane-induced nail changes are considered as an important cosmetic manifestation with an incidence that reaches up to 44% of patients treated with taxane-included therapeutic regimens. In this article, we represent a clinical observational study to evaluate the effect of cosmetic nail lacquer on taxane-induced nail changes in female patients diagnosed with breast cancer. Methods Prospectively, we identified those women who were diagnosed with breast cancer, scheduled to have AC-Taxol protocol. Any female with previous dermatological or systemic disorders that affect nails was excluded from the study. Patients were categorized into 2 groups based on the utilization of nail lacquer. The first group includes women who started to use the nail lacquer after development of nail changes. The second group comprises those women who did not use the nail lacquer at any occasion. Results A total of 59 female patients were included in the study; 46 (78%) of them developed nail changes and the main change was nail discoloration. The first group which has used nail lacquer (17, 28.8%) showed an improvement among 15 (78.9%) patients, whereas 2 (7.4%) of them continued to have worsening symptoms. On the contrary, most of the second group (25, 92.9%) did not show any improvement in nail changes. A statistical significance between the tested groups was observed (P = .000). There is no statistical association between the progression of nail changes and the age of patients. Conclusions Taxane-induced nail changes are considered as an important clinical, cosmetic, and psychological complication, especially for female patients with cancer. This article suggests that nail lacquer may have an effect in the improvement of nail changes, especially nail discoloration. Further investigations are recommended to prove the efficacy of nail lacquer.
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Affiliation(s)
- Osama Alshari
- Department of Internal Medicine, Division of Oncology, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | | | - Ahmed H Al Sharie
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Ala'a Msameh
- King Abdullah University Hospital, Irbid, Jordan
| | - Isra Al-Omari
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Renad Msameh
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Abdallah Almegdadi
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Dima Albals
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
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Alizadeh N, Mirpour SH, Darjani A, Rafiei R, Rafiei E, Mohammadhoseini M. Dermatologic adverse effects of breast cancer chemotherapy: a longitudinal prospective observational study with a review of literature. Int J Dermatol 2020; 59:822-828. [PMID: 32406107 DOI: 10.1111/ijd.14916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 01/31/2020] [Accepted: 04/14/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Breast cancer patients may experience an increased chance of survival with adjuvant chemotherapy. However dermatologic adverse effects can cause major discomfort due to physical or cosmetic problems. This study aims to describe dermatologic complications in breast cancer patients during chemotherapy. METHODS This longitudinal prospective observational study included data on women with non-metastatic breast cancer whom were treated with AC-T protocol (anthracycline, cyclophosphamide, and taxane) adjuvant chemotherapy and consecutively enrolled during two years. The study was performed in an educational and tertiary referral center. The patients' information including age, body mass index (BMI), past medical history, and different dermatologic complications were collected for all participants. RESULTS Of 190 enrolled women, all patients experienced alopecia, which occurred in 131 patients (68.9%) after the first cycle. Skin, mucosal, and nail involvement were respectively seen in 46 (24.2%), 51 (26.8%), and 86 (45.2%) cases. Cutaneous complications were observed mainly between the third and sixth chemotherapy cycles. Palmoplantar erythema and palmoplantar dysesthesia were the most common cutaneous complications. Dermatologic adverse effects were significantly more frequent in the patients with an underlying disease. CONCLUSION These findings suggest that dermatologic adverse effects of adjuvant chemotherapy are common and could be induced by all components of AC-T regimen. These complications should be skillfully managed to increase patients' comfort.
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Affiliation(s)
- Narges Alizadeh
- Skin Research Center, Department of Dermatology, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyyed Hossein Mirpour
- Department of Hematology and Oncology, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Abbas Darjani
- Skin Research Center, Department of Dermatology, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Rana Rafiei
- Skin Research Center, Department of Dermatology, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Rafiei
- Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran
| | - Maryam Mohammadhoseini
- Skin Research Center, Department of Dermatology, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
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10
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Ferreira MN, Ramseier JY, Leventhal JS. Dermatologic conditions in women receiving systemic cancer therapy. Int J Womens Dermatol 2019; 5:285-307. [PMID: 31909148 PMCID: PMC6938835 DOI: 10.1016/j.ijwd.2019.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/12/2019] [Accepted: 10/13/2019] [Indexed: 12/24/2022] Open
Abstract
As advances in cancer therapies have improved cancer-related survival, novel therapeutics have also introduced a variety of dermatologic toxicities, and an increased number of patients are living with these sequalae. Women with cancer in particular experience a spectrum of dermatologic conditions that affect their skin, hair, nail, and mucosal surfaces. Studies have shown that these toxic effects can significantly affect quality of life and alter a woman's self-image, cultural identity, femininity, sexuality, and mental health. In severe instances, dermatologic toxicities may even disrupt cancer therapy and can therefore affect overall survival and treatment response. In this article, we review the dermatologic adverse effects from traditional chemotherapy, targeted therapy, immune checkpoint inhibitors, and endocrine therapy that disproportionately affect women. The timely diagnosis and management of these dermatologic conditions is crucial in the multidisciplinary care of women with cancer.
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11
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Peyton L, Fischer-Cartlidge E. Extremity Cooling: A Synthesis of Cryotherapy Interventions to Reduce Peripheral Neuropathy and Nail Changes From Taxane-Based Chemotherapy. Clin J Oncol Nurs 2019; 23:522-528. [PMID: 31538978 DOI: 10.1188/19.cjon.522-528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Taxane-based chemotherapies are frequently used to treat solid tumor cancers. Two significant side effects include nail changes and/or peripheral neuropathy. These side effects can cause pain, infections, dose reductions, and treatment delays, all of which negatively affect quality of life. OBJECTIVES This article synthesizes the literature on efficacy and tolerability of extremity cryotherapy during taxane administration to identify if it is an intervention that can be provided to patients to mitigate these symptoms. METHODS A literature review was performed using PubMed®, the Cochrane Database of Systematic Reviews, Ovid, Web of Science, and CINAHL®. 46 articles were initially identified, and 10 articles were reviewed (5 related to nail changes and 5 related to neuropathy). FINDINGS Larger, powered studies are needed on these topics; however, existing data suggest this intervention as a promising low-risk option for mitigating the severity of nail changes and peripheral neuropathy related to taxane chemotherapy.
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Ruddy KJ, Le-Rademacher J, Lacouture ME, Wilkinson M, Onitilo AA, Vander Woude AC, Grosse-Perdekamp MT, Dockter T, Tan AD, Beutler A, Loprinzi CL. Randomized controlled trial of cryotherapy to prevent paclitaxel-induced peripheral neuropathy (RU221511I); an ACCRU trial. Breast 2019; 48:89-97. [PMID: 31590108 DOI: 10.1016/j.breast.2019.09.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 02/08/2023] Open
Abstract
PURPOSE This pilot trial aimed to assess if cooling hands and feet with crushed ice during receipt of paclitaxel helps prevent peripheral neuropathy. METHODS This prospective, randomized trial compared cryotherapy to standard care in patients initiating paclitaxel weekly x 12. For those on cryotherapy, hands and feet were cooled starting 15 min prior to and ending 15 min after each paclitaxel dose. EORTC QLQ-CIPN20 was completed at baseline, weekly x12, then monthly x6. Area under the curve (AUC) was calculated for subscale scores, adjusting for baseline, and compared between arms (Wilcoxon rank-sum test). Cross-study comparisons used data from 2 prior similarly-conducted neuropathy trials. RESULTS Forty-six patients were accrued. Three withdrew and one was ineligible. Of the remaining 42 (21 cryotherapy, 21 control), 39 (19 cryotherapy, 20 control) were analyzable for AUC. Cryotherapy was well tolerated, but the AUC of the CIPN20 sensory scores over 12 weeks of paclitaxel was not found to differ between the study arms (mean difference 3.45, 95% CI -3.13 to 10.02, p = 0.26). However, the control arm of the current trial experienced less neuropathy than did the placebo arms of two previous similar trials. When our cryotherapy arm was compared to the combined control arms from all three trials, the cryotherapy arm had less neuropathy (Wilcoxon Rank-Sum p = 0.01). CONCLUSION While there was no difference in CIPN20 scores identified between the 2 study arms in the current phase II trial, further investigation is needed given that the control arm experienced less neuropathy than was expected.
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Affiliation(s)
- Kathryn J Ruddy
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Jennifer Le-Rademacher
- Department of Biostatistics, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Mario E Lacouture
- Department of Dermatology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA
| | - Mary Wilkinson
- Inova Hematology Oncology, 8501 Arlington Blvd., Suite 340, Fairfax, VA, 22031, USA
| | - Adedayo A Onitilo
- Marshfield Clinic - Weston Center, 3501 Cranberry Blvd., Weston, WI, 54476, USA
| | - Amy C Vander Woude
- Cancer and Hematology Centers of Western Michigan, 145 Michigan St. NE, #3100, Grand Rapids, MI, 49503, USA
| | | | - Travis Dockter
- Department of Biostatistics, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Angelina D Tan
- Department of Biostatistics, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Andreas Beutler
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Charles L Loprinzi
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
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Huang KL, Lin KY, Huang TW, Loh EW, Hua YM, Su HC, Tam KW. Prophylactic management for taxane-induced nail toxicity: A systematic review and meta-analysis. Eur J Cancer Care (Engl) 2019; 28:e13118. [PMID: 31184794 DOI: 10.1111/ecc.13118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/27/2019] [Accepted: 05/14/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This meta-analysis was performed to assess the efficacy of cryotherapy and nail solution (NS) use in preventing nail toxicity (NT) induced by taxane-based chemotherapy. METHODS PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov registry databases were searched for relevant studies published up to December 2018. The primary outcome was taxane-induced NT. Secondary outcomes were skin toxicity (ST), time to toxicity and patient comfort. RESULTS We reviewed three randomised control trials and six prospective studies with 708 patients. For meta-analysis, taxane-induced NT grading was compared. NT and ST were significantly lower in the cryotherapy patients than in the controls (grade 1 NT: risk ratio [RR] = 0.51, 95% confidence interval [CI] = 0.30-0.89; grade 2-3 NT: RR = 0.36, 95% CI = 0.11-1.12; total NT: RR = 0.49; 95% CI = 0.30-0.79; ST: RR = 0.46, 95% CI = 0.33-0.64). The NS-treated patients exhibited significantly lower NT than the controls. CONCLUSIONS Nail solution-treated or cryotherapy patients exhibited lower NT incidence and severity associated with taxane-based chemotherapy than the controls. For patients who can afford and comply with NS use or cryotherapy, these measures represent effective prophylactic management for taxane-induced NT and improve their quality of life and functional statuses. Further studies are needed to establish the routine usage protocols, long-term efficacy and safety for these interventions.
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Affiliation(s)
- Kai-Ling Huang
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Yu Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tsai-Wei Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
| | - El-Wui Loh
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.,Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Ming Hua
- Department of Pharmacy, Chi Mei Medical Center, Tainan City, Taiwan
| | - Hui-Chen Su
- Department of Pharmacy, Chi Mei Medical Center, Tainan City, Taiwan
| | - Ka-Wai Tam
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.,Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
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Marks DH, Qureshi A, Friedman A. Evaluation of Prevention Interventions for Taxane-Induced Dermatologic Adverse Events. JAMA Dermatol 2018; 154:1465-1472. [DOI: 10.1001/jamadermatol.2018.3465] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Dustin H. Marks
- The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Azam Qureshi
- Department of Dermatology, The George Washington University Medical Faculty Associates, Washington, DC
| | - Adam Friedman
- The George Washington University School of Medicine and Health Sciences, Washington, DC
- Department of Dermatology, The George Washington University Medical Faculty Associates, Washington, DC
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Localised Model-Based Active Controlling of Blood Flow During Chemotherapy to Prevent Nail Toxicity and Onycholysis. J Med Biol Eng 2018. [DOI: 10.1007/s40846-018-0416-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Taxanes (docetaxel and paclitaxel) are among the most commonly prescribed anticancer drugs approved for the treatment of metastatic or locally advanced breast, non-small cell lung, prostate, gastric, head and neck, and ovarian cancers, as well as in the adjuvant setting for operable node-positive breast cancers. Although the true incidence of dermatological adverse events (AEs) in patients receiving taxanes is not known, and has never been prospectively analysed, they clearly represent one of the major AEs associated with these agents. With an increase in the occurrence of cutaneous AEs during treatment with novel targeted and immunological therapies when used in combination with taxanes, a thorough understanding of reactions attributable to this class is imperative. Moreover, identification and management of dermatological AEs is critical for maintaining the quality of life in cancer patients and for minimizing dose modifications of their antineoplastic regimen. This analysis represents a systematic review of the dermatological conditions reported with the use of these drugs, complemented by experience at comprehensive cancer centres. The conditions reported herein include skin, hair, and nail toxicities. Lastly, we describe the dermatological data available for the new, recently FDA-and EMA- approved, solvent-free nab-paclitaxel.
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Comparaison de différents vernis à ongles en matière d’efficacité photoprotectrice. Étude de l’intérêt de leur recours en soins de support en oncologie. Bull Cancer 2016; 103:612-21. [DOI: 10.1016/j.bulcan.2016.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 03/22/2016] [Accepted: 03/27/2016] [Indexed: 11/19/2022]
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18
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Yorulmaz A, Dogan M, Artuz F, Zengin N. Comparison of pigmentary side effects of taxanes and anthracyclines: an onychoscopic evaluation. Cutan Ocul Toxicol 2016; 36:135-139. [DOI: 10.3109/15569527.2016.1173698] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Mutlu Dogan
- Department of Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | | | - Nurullah Zengin
- Department of Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey
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Kadakia KC, Rozell SA, Butala AA, Loprinzi CL. Supportive cryotherapy: a review from head to toe. J Pain Symptom Manage 2014; 47:1100-15. [PMID: 24210702 PMCID: PMC4013268 DOI: 10.1016/j.jpainsymman.2013.07.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 07/17/2013] [Accepted: 07/23/2013] [Indexed: 11/26/2022]
Abstract
CONTEXT Conventional chemotherapy leads to multiple adverse mucocutaneous complications such as oral mucositis, alopecia, ocular toxicity, and onycholysis. Limited pharmacologic interventions are available for preventing these clinical problems. OBJECTIVES This study aimed to critically review the role of cryotherapy (regional hypothermia) for alleviating these adverse symptoms. METHODS A narrative review was performed, with an emphasis on randomized controlled trials. A comprehensive search using PubMed, Ovid, Embase, and MEDLINE(®) was completed. References of all cited articles also were reviewed. Data from the review were composed of articles published between 1970 and May 2013. RESULTS Available evidence suggests that regional hypothermia decreases the burden of chemotherapy-related oral mucositis, alopecia, ocular toxicity, and onycholysis. The major limitations of studies include the absence of blinded control groups and variable clinical end points. CONCLUSION Regional hypothermia decreases the burden of these four chemotherapy-induced complications and is well tolerated. More research is needed to determine what subgroups of cancer patients are most likely to respond to different types of regional hypothermia, the ideal duration of cooling needed, and further improve the ease of use of the cooling devices.
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Affiliation(s)
- Kunal C Kadakia
- Division of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Shaina A Rozell
- Division of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Anish A Butala
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Ho MY, Mackey JR. Presentation and management of docetaxel-related adverse effects in patients with breast cancer. Cancer Manag Res 2014; 6:253-9. [PMID: 24904223 PMCID: PMC4041377 DOI: 10.2147/cmar.s40601] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The taxane chemotherapeutic agent docetaxel has been utilized in the management of breast cancer in the adjuvant, neoadjuvant and metastatic setting. Although well tolerated by the majority of patients, docetaxel toxicity may limit the dose which can be administered. Adverse events include infusion reactions, febrile neutropenia, fatigue, fluid retention, pneumonitis, cutaneous and nail toxicity, epiphora and lacrimal duct stenosis, gastrointestinal complications, and neuropathies. In this review, we explore these complications and how they can be effectively managed to improve patient quality of life during and following docetaxel therapy.
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Affiliation(s)
- Maria Y Ho
- Division of Medical Oncology, Cross Cancer Institute, Edmonton, AB, Canada
| | - John R Mackey
- Division of Medical Oncology, Cross Cancer Institute, Edmonton, AB, Canada
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Akoglu G. Docetaxel-induced palmoplantar erythrodysesthesia syndrome and long-lasting multiple nail changes. Indian J Pharmacol 2014; 46:225-7. [PMID: 24741199 PMCID: PMC3987196 DOI: 10.4103/0253-7613.129326] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 08/10/2013] [Accepted: 01/12/2014] [Indexed: 01/28/2023] Open
Abstract
Palmoplantar erythrodysesthesia syndrome (PPES) and nail changes are common presentations of cutaneous toxicity of docetaxel chemotherapy, which deteriorate the quality of life of patients. Herein, we describe a female patient who developed PPES and multiple nail changes due to docetaxel treatment for infiltrative ductal carcinoma. Cold application and elevation of extremities during docetaxel infusion, potent topical steroids and oral pyridoxine increased the tolerance to chemotherapy and provided regression of painful cutaneous lesions without cessation of the treatment.
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Affiliation(s)
- Gulsen Akoglu
- Dermatology Clinic, Ankara Halil Sivgin Cubuk State Hospital, Ankara, Turkey
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McCarthy AL, Shaban RZ, Gillespie K, Vick J. Cryotherapy for docetaxel-induced hand and nail toxicity: randomised control trial. Support Care Cancer 2013; 22:1375-83. [PMID: 24362908 DOI: 10.1007/s00520-013-2095-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 12/05/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE This study investigated the efficacy and safety of cryotherapy, in the form of frozen gel gloves, in relation to docetaxel-induced hand and fingernail toxicities. PATIENTS AND METHODS After piloting with 21 patients, a consecutive series sample of patients (n=53) prescribed docetaxel every 3 weeks, for a minimum of three cycles, was enrolled in this randomised control trial. Participants acted as their own control, with the frozen gel glove worn on one randomised hand for 15 min prior to infusion, for the duration of the infusion, and for 15 min of after completion of treatment. Hand and nail toxicities were evaluated by two blinded assessors according to CTCAE.v4 criteria. To assess the potential for cross-infection of multi-use gloves, microbial culture and sensitivity swabs were taken of each glove at every tenth use. RESULTS Of the 53 participants enrolled in the main study, 21 provided evaluable data. There was a 60 % withdrawal rate due to patient discomfort with the intervention. The mean incidence and severity of toxicities in all evaluable cycles in control and intervention hands respectively were erythroderma grade 1 (5/5 %), nail discolouration grade 1 (81/67 %), nail loss grade 1 (19/19 %) and nail ridging grade 1 (57/57 %). No significant differences were determined between hand conditions in terms of time to event, nor in terms of toxicity in gloved and non-gloved hands. CONCLUSION While cryotherapy in the form of frozen gloves for the cutaneous toxicities associated with docetaxel is safe, its limited efficacy, patient discomfort and some logistical issues preclude its use in our clinical setting.
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Eckhoff L, Knoop AS, Jensen MB, Ejlertsen B, Ewertz M. Risk of docetaxel-induced peripheral neuropathy among 1,725 Danish patients with early stage breast cancer. Breast Cancer Res Treat 2013; 142:109-18. [DOI: 10.1007/s10549-013-2728-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 10/03/2013] [Indexed: 10/26/2022]
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Swenson KK, Bell EM, Nissen J. Nail toxicity associated with paclitaxel treatment for ovarian cancer. Oncol Nurs Forum 2012; 40:17-9. [PMID: 23269765 DOI: 10.1188/13.onf.17-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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