Upper and Lower limb cryotherapy as a preventive strategy for taxane-induced peripheral neuropathy in breast cancer patients: a systematic review and meta-analysis

Peripheral neuropathy is a well-known complication in patients undergoing taxane chemotherapy. Several measures to prevent this condition have been tried, but none have yielded conclusive results. MEDLINE, Embase, Cochrane, and Web of Science databases were searched for randomized (RCTs) and self-controlled (SCTs) trials comparing cryotherapy with standard care in patients with breast cancer undergoing taxane-based chemotherapy and reporting any of the following outcomes: (1) chemotherapy-induced peripheral neuropathy (CIPN) or (2) adverse events. A total of 395 patients from ten studies were included, all female. The age of participants ranged from 49.8 to 56.1 years. Incidence of any-grade CIPN was not significantly different between groups (RCTs RR 0.59; 95% CI 0.21-1.66; <i>p</i> = 0.320; SCTs RR 0.40; 95% CI 0.10-1.62; <i>p</i> = 0.198). No difference was observed in adverse events leading to discontinuation of cryotherapy (RCTs RR 0.72; 95% CI 0.17-3.05; <i>p</i> = 0.660; SCTs RR 1.09; 95% CI 0.51-2.34; <i>p</i> = 0.821). Cryotherapy was not statistically superior to the standard of care in reducing CIPN, without an increased risk of adverse events leading to discontinuation of cryotherapy. These findings underscore the need for further studies with more rigorous methodologies to definitively validate or rule out this finding. PROSPERO (CRD420251018990).