The Study Of Clinical Efficacy And Safety Of Compression Therapy For Chemotherapy-induced Peripheral Neuropathy In Breast Cancer

Objective: The study aims to investigate the clinical efficacy and safety of compression therapy as an inexpensive and simple way to prevent and relieve chemotherapy-induced peripheral neuropathy(CIPN)in breast cancer.Methods: 176 breast cancer women patients who received nanoparticle albumin bound-Paclitaxel(nab-PTX)chemotherapy from Jun.2021 to Dec.2022 in Yunnan Cancer Hospital enrolled in the study,they were randomly divided into 5experimental and a control groups.The experimental subgroup 1 worn double-layer of surgical gloves small 1 continuously for 60 minutes,subgroup 2 worn double-layer of surgical gloves small 1 for 60 minutes by the intermittent compression mode,subgroup 3 worn double-layer of surgical gloves small 1 continuously for 30 minutes,subgroup 4 worn double-layer of surgical gloves small 2 continuously for 60 minutes,and subgroup 5 worn the self-inflating pressurized rings continuously for 60 minutes.There were no interventions for CIPN in the control group.The subjective evaluation indicators were National Cancer Institute-Common Terminology Criteria for Adverse Events(NCI-CTCAE)and Patient Neurotoxicity Questionnaire(PNQ).The objectively evaluate indicators included the reduction of fingertips’ temperature and operational dexterity delay,and the incidence of sensory disturbances of heat,cold and vibration.The above datas were statistically analyzed to explore the clinical efficacy and safety of compression therapy in preventing and relieving CIPN in breast cancer,and to discover appropriate timing of intervention,duration and pressure intensity,and to explore the efficacy of the intermittent compression mode and the self-inflating pressurized ring.Results:1.Clinical efficacy of compression therapy Subgroups 1,2,4,and 5 benefited in the incidence of sensory and motor events for both CTCAE and PNQ compared with the control group(p<0.05).Then the incidence of ≥2 CTCAE events,sensory neuropathy: subgroup 1 19.4%,the control group61.3%;motor neuropathy: subgroup 1 16.1%,the control group 58.1%;≥D PNQ evens,sensory symptoms: subgroup 1 6.5%,the control group 51.6%;motor symptoms: subgroup 1 3.2%,control group 25.8%.So,compression therapy could reduce the incidence of ≥2 CTCAE and ≥D PNQ both sensory and motor events.Patients could reduce the fingertips’ temperature by 2.0-2.2°C by compression therapy in the experimental groups;the delay times of operational dexterity were 2.7-3.5s in the experimental groups and 8.5-10.8s in the control group(p<0.001).Only subgroups1 and 4 reduced the incidence of heat sensory disturbance(p<0.05),but the results of cold and vibration sensations were meaningless(p>0.10).2.Safety of compression therapy In the study,all patients showed good tolerability of pressure intensity and didn’t show other adverse reactions.3.Exploring the standard of compression therapy In the control group,the incidence and severity of CIPN with a noticeable increase after the 2nd cycle in both CTCAE and PNQ.There was no statistically significant difference between subgroup 3 and control group in the comparison of CTCAE sensory event(p=0.055),then subgroup 1 could further reduce the incidence of CTCAE motor events compared with subgroup 3(p=0.048).So the efficacy was better when compression therapy were 60 minutes.When subgroup 4 and subgroup 1 were compared,there were no significant differences in all indicators(p≥0.05),and the efficacy of double-layer small 1 and small 2 surgical gloves were comparable.Although subgroups 1 and 3 didn’t differ in CTCAE sensory and PNQ sensory and motor events(p>0.05),subgroups 4 and 3benefited from the comparison of above(p<0.05),in addition,subgroup 4 increased both compression duration and stress to subgroup 3.When subgroups 2 and 5 were compared with subgroup 1,there were no significant differences in all indicators(p>0.05).The intermittent wearing mode was comparable to the continuous wearing mode,and the self-inflating pressurized ring was comparable to the double-layer surgical gloves small 1.Conclusions:1.Compression therapy can reduce the incidence and severity of CIPN in breast cancer.2.Compression therapy should be started before the 2nd cycle of chemotherapy, preferably from the 1st cycle.And compression therapy is recommended for 60 minutes,the intermittent compression mode is a safe way which efficacy is accurate.3.The double-layer medical surgical gloves as an inexpensive and simple compression method clinical efficacy is accurate,and it’s pressure intensity is controlled within the range of double-layer surgical gloves small 1.4.The self-inflating pressurized ring is an intermittent compression equipment with adjustable pressure,universal hands and feet,and definite clinical effect,which has applied for a national patent.5.The methods,durations and pressure intensities of compression therapy didn’t cause acral compression-related injuries in this study,which are safe and feasible.