Prophylactic management for taxane‐induced nail toxicity: A systematic review and meta‐analysis

• Published in: European journal of cancer care Vol. 28; no. 5; pp. e13118 - n/a
• Main Authors: Huang, Kai‐Ling, Lin, Kuan‐Yu, Huang, Tsai‐Wei, Loh, El‐Wui, Hua, Yi‐Ming, Su, Hui‐Chen, Tam, Ka‐Wai
• Format: Journal Article
• Language: English
• Published: England Hindawi Limited 01.09.2019
• Subjects: Chemotherapy; Clinical trials; Confidence intervals; Cryotherapy; Cryotherapy - methods; Docetaxel - adverse effects; Evaluation; Evidence-based medicine; Fingernail; frozen gloves; Hands; Humans; Meta-analysis; Nail Diseases - chemically induced; Nail Diseases - prevention & control; nail solution; nail toxicity; Neoplasms - drug therapy; Nursing; Oils, Volatile - therapeutic use; onycholysis; Onycholysis - chemically induced; Onycholysis - prevention & control; Paclitaxel - administration & dosage; Paronychia - chemically induced; Paronychia - prevention & control; Pigmentation Disorders - chemically induced; Pigmentation Disorders - prevention & control; Plant Oils - therapeutic use; Quality of life; Risk management; Skin; Systematic review; taxane; Taxanes; Taxoids - adverse effects; Toxicity; Waxes - therapeutic use; frozen gloves; onycholysis; nail solution; nail toxicity; cryotherapy; taxane; chemotherapy
• ISSN: 0961-5423; 1365-2354
• DOI: 10.1111/ecc.13118

Objective This meta‐analysis was performed to assess the efficacy of cryotherapy and nail solution (NS) use in preventing nail toxicity (NT) induced by taxane‐based chemotherapy. Methods PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov registry databases were searched for relevant studies published up to December 2018. The primary outcome was taxane‐induced NT. Secondary outcomes were skin toxicity (ST), time to toxicity and patient comfort. Results We reviewed three randomised control trials and six prospective studies with 708 patients. For meta‐analysis, taxane‐induced NT grading was compared. NT and ST were significantly lower in the cryotherapy patients than in the controls (grade 1 NT: risk ratio [RR] = 0.51, 95% confidence interval [CI] = 0.30–0.89; grade 2–3 NT: RR = 0.36, 95% CI = 0.11–1.12; total NT: RR = 0.49; 95% CI = 0.30–0.79; ST: RR = 0.46, 95% CI = 0.33–0.64). The NS‐treated patients exhibited significantly lower NT than the controls. Conclusions Nail solution‐treated or cryotherapy patients exhibited lower NT incidence and severity associated with taxane‐based chemotherapy than the controls. For patients who can afford and comply with NS use or cryotherapy, these measures represent effective prophylactic management for taxane‐induced NT and improve their quality of life and functional statuses. Further studies are needed to establish the routine usage protocols, long‐term efficacy and safety for these interventions.