Molpus, K.L., Anderson, L.B., Craig, C.L., & Puleo, J.G. (2004). The effect of regional cooling on toxicity associated with intravenous infusion of pegylated liposomal doxorubicin in recurrent ovarian carcinoma. Gynecologic Oncology, 93, 513–516.

To evaluate the effectiveness of regional cooling on palmar-plantar erythrodysesthesia (PPE).

Patients received pegylated liposomal doxorubicin (PLD) every 28 days, with dosages ranging from 30 mg/m² to 50 mg/m².

Group 1 (n = 17) used regional cooling. The regional cooling protocol (RCP) included administration of ice packs to the wrists and ankles, and iced liquids were available for consumption during PLD infusion. In addition, patients were encouraged to use the ice packs for up to 24 hours after completion of the PLD infusion.

Group 2 (n = 3) did not use RCP. Patients were instructed to avoid ingestion of hot foods or liquids, avoid contact with hot water and direct sunlight, and minimize friction to the hands and feet for 72 hours post-PLD treatment.

• The study reported on a sample of 20 female patients with recurrent epithelial ovarian cancer who received PLD.
• The median number of PLD cycles was five.

University of Nebraska Medical Center in Omaha

This was a retrospective analysis of 20 patients’ records.

PPE was graded from 1 to 4; however, the authors did not specify what grading system was used.

The frequency and severity of PPE was reduced in 17 women who used the RCP, compared to three women who did not use those measures (p = 0.047).

Regional cooling around the wrists and ankles was well tolerated and had a high degree of compliance during chemotherapy administration.

• This was a retrospective review of records.
• The sample size was small.
• The description of the measurement method used to grade PPE symptoms was insufficient; reliability and validity were unclear.