Prevention of Onycholysis During Cancer Treatment Using an Active Local Cooling Device: Comparison of Three Different Cooling Strategies

摘要

Nail changes are a common side effect of systemic chemotherapy. Onycholysis is a severe form of nail toxicity in which the nail detaches from the nail bed. Cryotherapy can be effective in preventing chemotherapy induced nail changes as it enables cold-induced vasoconstriction (CIVC), or reduction of blood flow, and therefore limits the transport of chemotherapeutic agents towards the nail beds. Unfortunately, CIVC is inevitably followed up by cold-induced vasodilation (CIVD), causing the blood flow to increase again which reduces the effectiveness of the treatment. Moreover, the local use of extremely low temperatures induce pain and additional distress during chemo treatment. The objective of this article is to examine the usefulness of an active local cooling device for controlling blood flow in the fingertips and reducing CIVD, while limiting pain and discomfort. Three different cooling strategies are evaluated to compare their effectiveness in reducing CIVD. It is hypothesized that pulsating cooling reduces CIVD as it may limit body heat storage during the treatment.