{"entity":{"id":"limb-cryocompression-devices","kind":"technology","name":"Limb cryocompression devices for chemotherapy nerve damage (Paxman Neuropathy System, Hilotherm ChemoCare)","aka":["Limb cryocompression","Paxman Neuropathy System","Paxman Limb Cryocompression System","Hilotherm ChemoCare","Cryocompression"],"tldr":"Machine-cooled wraps that chill and gently squeeze the hands and feet during chemotherapy, in the hope of keeping drug away from the nerves that cause numbness and tingling. They are the machine version of frozen gloves, and the trials so far give mixed answers.","summary":"Frozen gloves and tight surgical gloves reduced taxane neuropathy in small self-controlled studies (Hanai et al., JNCI 2018: hand neuropathy 27.8 against 80.6 per cent; Tsuyuki et al. 2016: grade 2 or worse sensory neuropathy 21.4 against 76.1 per cent). Cryocompression devices circulate cooled fluid through wraps with cyclic pressure, holding a steady temperature rather than letting frozen packs thaw. Paxman calls its Neuropathy System \"a cryocompression device for busy oncology clinics\", cooling hands and feet, and claims a 95 per cent relative risk reduction in grade 2 or worse neuropathy, a figure it footnotes as \"versus historical untreated control data\"; the company describes it as commercially available in the UK and it has no FDA 510(k). Hilotherm of Germany lists ChemoCare, a chemo glove and a chemo foot wrap with the FDA as water-circulating hot or cold packs, a listing rather than a clearance for neuropathy.\n\nThe randomised evidence is mixed. In CROPSI (200 patients) grade 2 or worse neuropathy was 13.7 per cent with cryotherapy and 17.2 per cent with cryocompression, and \"cryocompression was not more effective than cryotherapy alone\". In the Duke self-controlled trial in gynaecological cancer, cryocompression lowered the odds of patient-reported sensory neuropathy (odds ratio 0.54) without a difference on monofilament testing. In CONTRoL, compression succeeded in 64.7 per cent against 41.1 per cent for both cryotherapy and placebo, and adherence was 72.7 against 35.0 per cent, so whether patients keep the cold on matters. A 2024 meta-analysis of seven frozen-glove trials found the effect inconclusive. SWOG's phase 3 ICE COMPRESS trial (777 planned) is comparing cooling and compression approaches and is the trial expected to settle the question; oxaliplatin, whose nerve toxicity is worsened by cold, is not a candidate.","status":"emerging","asOf":"2026-11-04","links":[{"label":"Paxman: the Paxman Neuropathy System (limb cryocompression)","url":"https://paxmangroup.com/reduce-nerve-damage/paxman-neuropathy/"},{"label":"openFDA registration listing: Hilotherm GmbH (ChemoCare, chemo glove)","url":"https://api.fda.gov/device/registrationlisting.json?search=registration.name:%22HILOTHERM%22"},{"label":"Hanai et al., frozen gloves and socks during weekly paclitaxel, self-controlled trial (JNCI 2018)","url":"https://doi.org/10.1093/jnci/djx178"},{"label":"Tsuyuki et al., surgical-glove compression during nab-paclitaxel, phase 2 (Breast Cancer Res Treat 2016)","url":"https://doi.org/10.1007/s10549-016-3977-7"},{"label":"Bandla et al., safety of continuous-flow limb cryocompression in 13 patients (Support Care Cancer 2020)","url":"https://doi.org/10.1007/s00520-019-05177-2"},{"label":"Brunner et al., CROPSI: cryotherapy against cryocompression in 200 patients (The Breast 2024)","url":"https://doi.org/10.1016/j.breast.2024.103763"},{"label":"Anastasio et al., cryocompression during gynaecological chemotherapy, self-controlled randomised trial (Obstet Gynecol 2023)","url":"https://doi.org/10.1097/aog.0000000000005419"},{"label":"Accordino et al., CONTRoL phase 2B: cryotherapy against compression against placebo (Breast Cancer Res Treat 2024)","url":"https://doi.org/10.1007/s10549-023-07172-y"},{"label":"Wu et al., frozen gloves for neuropathy prevention: meta-analysis of 7 trials (Front Oncol 2024)","url":"https://doi.org/10.3389/fonc.2024.1366782"},{"label":"ClinicalTrials.gov NCT05642611","url":"https://clinicaltrials.gov/study/NCT05642611"}],"tags":["machines-wave3"],"related":["idea-moon-neuropathy-prevention-programme","idea-mach-cold-or-compression-by-adherence"],"cancers":["breast-cancer","ovarian","endometrial"],"sections":["supportive-care","chemotherapy","devices"],"technologies":["frozen-gloves-compression-taxane","scalp-cooling","oncology-infusion-chairs"],"targets":[],"drugs":["paclitaxel","docetaxel"],"companies":["paxman","hilotherm"],"institutions":[],"pathways":[],"terms":[],"trials":["ice-compress-swog","control-cipn-trial","duke-cryocompression-gyn","dfci-paxman-limb-cryocompression","nuh-limb-cryocompression-expansion"],"people":[],"bottlenecks":["b-toxicity-qol","b-survivorship"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"provenance":{"editedBy":"OnCo machines inventory (openFDA, accessdata.fda.gov, ClinicalTrials.gov v2, Europe PMC, maker pages)","editedOn":"2026-11-04"},"principle":"Cooling to around 16 to 24 degrees Celsius with cyclic pressure narrows blood vessels in the hands and feet during the infusion peak, reducing drug delivery to peripheral nerves.","strengths":["Steady temperature without swapping frozen packs","Self-controlled and randomised trials under way, including a 777-patient phase 3","Same principle as scalp cooling, delivered in the same chair"],"limitations":["Randomised results mixed; not better than cryotherapy alone in CROPSI","No FDA clearance for neuropathy prevention","Cold is unsuitable with oxaliplatin; adherence falls with discomfort"]},"route":"/technologies/limb-cryocompression-devices/","neighbours":{"idea":[{"id":"idea-moon-neuropathy-prevention-programme","kind":"idea","name":"A prevention programme for chemotherapy nerve damage: SARM1 inhibitors, cooling and compression","route":"/ideas/idea-moon-neuropathy-prevention-programme/"},{"id":"idea-mach-cold-or-compression-by-adherence","kind":"idea","name":"Choose cold or compression for neuropathy by what patients can keep on","route":"/ideas/idea-mach-cold-or-compression-by-adherence/"}],"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"endometrial","kind":"cancer","name":"Endometrial cancer","route":"/cancers/endometrial/"},{"id":"ovarian","kind":"cancer","name":"Ovarian cancer","route":"/cancers/ovarian/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"devices","kind":"section","name":"Devices & Physical Therapies","route":"/fronts/devices/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"frozen-gloves-compression-taxane","kind":"technology","name":"Frozen gloves, socks and compression for taxane nail and nerve damage","route":"/technologies/frozen-gloves-compression-taxane/"},{"id":"oncology-infusion-chairs","kind":"technology","name":"Oncology infusion and treatment chairs","route":"/technologies/oncology-infusion-chairs/"},{"id":"scalp-cooling","kind":"technology","name":"Scalp cooling (cold caps: DigniCap, Paxman)","route":"/technologies/scalp-cooling/"}],"drug":[{"id":"docetaxel","kind":"drug","name":"Docetaxel","route":"/drugs/docetaxel/"},{"id":"paclitaxel","kind":"drug","name":"Paclitaxel / nab-paclitaxel","route":"/drugs/paclitaxel/"}],"company":[{"id":"hilotherm","kind":"company","name":"Hilotherm","route":"/companies/hilotherm/"},{"id":"paxman","kind":"company","name":"Paxman","route":"/companies/paxman/"}],"trial":[{"id":"control-cipn-trial","kind":"trial","name":"CONTRoL (cryotherapy against compression for neuropathy)","route":"/trials/control-cipn-trial/"},{"id":"dfci-paxman-limb-cryocompression","kind":"trial","name":"Dana-Farber trial of the Paxman limb cryocompression system","route":"/trials/dfci-paxman-limb-cryocompression/"},{"id":"duke-cryocompression-gyn","kind":"trial","name":"Duke cryocompression trial in gynaecological cancer","route":"/trials/duke-cryocompression-gyn/"},{"id":"ice-compress-swog","kind":"trial","name":"ICE COMPRESS (SWOG, cooling or compression of limbs to prevent neuropathy)","route":"/trials/ice-compress-swog/"},{"id":"nuh-limb-cryocompression-expansion","kind":"trial","name":"Singapore limb cryocompression expansion study","route":"/trials/nuh-limb-cryocompression-expansion/"}],"bottleneck":[{"id":"b-survivorship","kind":"bottleneck","name":"Survivorship and late effects are neglected","route":"/bottlenecks/b-survivorship/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"roadmap":[{"id":"chemo-chair-comfort-devices-roadmap","kind":"roadmap","name":"Comfort devices at the chemotherapy chair: scalp cooling, cold caps, limb cryocompression and infusion chairs","route":"/roadmaps/chemo-chair-comfort-devices-roadmap/"}]}}