The effect of regional cooling on toxicity associated with intravenous infusion of pegylated liposomal doxorubicin in recurrent ovarian carcinoma.
OBJECTIVE
The purpose of this study is to determine if regional cooling reduces palmar-plantar erythrodysesthesia (PPE) associated with intravenous infusion of pegylated liposomal doxorubicin (PLD).


METHODS
A retrospective review over 3 years identified 20 women who were treated with single-agent intravenous PLD for recurrent ovarian carcinoma. During PLD infusion, patients kept ice packs around their wrists and ankles, and consumed iced liquids. These steps were continued for 24 h after completion of chemotherapy. All patients were instructed not to ingest hot food or liquids, to avoid contact with hot water, and to minimize friction on the hands and feet for 72 h posttreatment.


RESULTS
Seventeen of the twenty patients (85%) followed the regional cooling protocol, and three of twenty (15%) did not. In the group who underwent regional cooling, 16/17 (94%) had none to mild PPE (grades 0-2), and 1/17 (6%) had moderate to severe PPE (grades 3-4). Of the three patients without regional cooling, 1/3 (33%) had grades 0-2 PPE and 2/3 (67%) had grades 3-4 PPE (P = 0.047).


CONCLUSIONS
Regional cooling may reduce the frequency and severity of PPE associated with intravenous PLD infusion for recurrent ovarian carcinoma. Prospective, randomized evaluation is needed to confirm this observation.
Molpus
Kelly L
KL
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Nebraska Medical Center, Omaha, NE 68198-3255, USA. kmolpus@unmc.edu
Anderson
Lynne B
LB
Craig
Carin L
CL
Puleo
Joel G
JG
D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage* / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology / Q000517:prevention & control*; D004890:Erythema / Q000139:chemically induced / Q000517:prevention & control*; D005260:Female; D005533:Foot Dermatoses / Q000139:chemically induced / Q000517:prevention & control*; D006229:Hand Dermatoses / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D007036:Hypothermia, Induced; D007262:Infusions, Intravenous; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies
D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin