title: Supportive cryotherapy: a review from head to toe.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Kunal C
authors.initials: KC
authors.lastname: Kadakia
authors.affiliation: Division of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Shaina A
authors.initials: SA
authors.lastname: Rozell
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
authors.forename: Anish A
authors.initials: AA
authors.lastname: Butala
authors.affiliation: Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: cloprinzi@mayo.edu.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Loprinzi
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D017679:Cryotherapy / Q000379:methods*; D006801:Humans; D016032:Randomized Controlled Trials as Topic
chemical_list: D000970:Antineoplastic Agents
keywords: Cryotherapy; alopecia; mucositis; onycholysis; regional hypothermia