Multicenter study of a frozen glove to prevent docetaxel-induced onycholysis and cutaneous toxicity of the hand.
OBJECTIVE
Onycholysis and skin toxicity occur in approximately 30% of patients treated with docetaxel. We investigated the efficacy and safety of an Elasto-Gel (84400 APT Cedex, Akromed, France) frozen glove (FG) for the prevention of docetaxel-induced onycholysis and skin toxicity.


METHODS
Patients receiving docetaxel 75 mg/m2 alone or in combination chemotherapy were eligible for this case-control study. Each patient wore an FG for a total of 90 minutes on the right hand. The left hand was not protected and acted as the control. Onycholysis and skin toxicity were assessed at each cycle by National Cancer Institute Common Toxicity Criteria and documented by photography. Wilcoxon matched-pairs rank test was used.


RESULTS
Between August 2002 and September 2003, 45 patients were evaluated. Onycholysis and skin toxicity were significantly lower in the FG-protected hand compared with the control hand (P = .0001). Onycholysis was grade (G) 0 in 89% v 49% and G1 to 2 in 11% v 51% for the FG-protected hand and the control hand, respectively. Skin toxicity was G0 in 73% v 41% and G1 to 2 in 27% v 59% for the FG-protected and the control hand, respectively. Median time to nail and skin toxicity occurrence was not significantly different between the FG-protected and the control hand, respectively (106 v 58 days for nail toxicity; 57 v 58 days for skin toxicity). Five patients (11%) experienced discomfort due to cold intolerance.


CONCLUSIONS
FG significantly reduces the nail and skin toxicity associated with docetaxel and provides a new tool in supportive care management to improve a patient's quality of life.
Scotté
Florian
F
Department of Medical Oncology, Georges Pompidou European Hospital, 20 rue Leblanc, 75908, Paris Cedex 15, France. florian.scotte@hop.egp.ap-hop-paris.fr
Tourani
Jean-Marc
JM
Banu
Eugeniu
E
Peyromaure
Michel
M
Levy
Eric
E
Marsan
Sandrine
S
Magherini
Emmanuelle
E
Fabre-Guillevin
Elisabeth
E
Andrieu
Jean-Marie
JM
Oudard
Stéphane
S
D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D016022:Case-Control Studies; D000077143:Docetaxel; D005260:Female; D005615:Freezing; D017575:Gloves, Protective; D006801:Humans; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000139:chemically induced / Q000517:prevention & control*; D012871:Skin Diseases / Q000139:chemically induced / Q000517:prevention & control*; D043823:Taxoids / Q000009:adverse effects*
D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D000077143:Docetaxel