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

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 pub...

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Published in:European journal of cancer care 2019-09, Vol.28 (5), p.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: Article
Language:English
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
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Summary: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.
ISSN:0961-5423
1365-2354
DOI:10.1111/ecc.13118