Limb cryocompression devices for chemotherapy nerve damage (Paxman Neuropathy System, Hilotherm ChemoCare)

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.

The 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.