P0032 Effect of compression therapy on chemotherapy-induced peripheral neuropathy in breast cancer treatment: Investigation into restored skin microcirculation homeostasis. (July 2015)

• Record Type: Journal Article
• Authors: Ohno, T.; Mine, T.; Yoshioka, H.; Kosaka, M.; Matsuda, K.; de Kerckhove, M.; de Kerckhove, C.; Eguchi, S.; Matsuo, S.; Takashi, A.; Mishima, T.; Inoue, S.; Hamada, T.
• Is Part Of: European journal of cancer. Volume 51(2015)Supplement 2
• Page Start: e10
• Publication Date: 2015-07
• Subjects: Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2015.06.032
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract : Background: To prevent and treat chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients, our hospital applies a "3S" approach based on two concepts: compression therapy, using stockings and sleeves, and medication therapy, using selected prophylactic medications. Although we previously reported significantly superior peripheral neuropathy grade suppression and nab-paclitaxel dose maintenance in a 3S group compared to a control group, effects of 3S treatment on skin microcirculation homeostasis is unclear. The aim of this study was to study the effect of compression therapy on restoring skin microcirculation homeostasis patients with breast cancer with CIPN. Methods: This small-scale clinical study took place in a single centre in Nagasaki, Japan, and involved 22 patients with breast cancer who were treated with nab-paclitaxel with 3S treatment ( n = 44 lower limb samples) and a control group of 25 healthy female volunteers ( n = 50). Compression stockings were applied for 24 h on 47 participants (in patients treated with nab-paclitaxel, just before intravenous infusion). Tissue blood flow (TBF) of lower limbs was measured with a laser Doppler blood-flow metre, both before and after application. The main outcome measure was the Stability Index (SI; standard deviation of TBF/mean TBF), which represents TBF homeostasis, where low values indicate normal, stable blood flow and high values indicate impairment. Findings: In 44 patient samples, the mean SI decreased significantly after stocking use, from 11.6 ± 6.3 to 8.7 ± 3.4 ( p < 0.01). In 50 volunteer samples, the mean SI decreased from 8.3 ± 4.9 to 6.5 ± 2.5 ( p < 0.05) after stocking use. No harm was reported. Interpretation: Our study suggests that patients treated with nab-paclitaxel have poor tissue-fluid exchange homeostasis, relative to healthy controls, and that stable skin microcirculation may be effectively restored through compression therapy. Therefore, our 3S approach may alleviate CIPN by proactively maintaining skin microcirculation homeostasis and, thereby, also potentially raising drug clearance in the skin.