The effect of regional cooling on toxicity associated with intravenous infusion of pegylated liposomal doxorubicin in recurrent ovarian carcinoma.

Objective: The purpose of this study is to determine if regional cooling reduces palmar-plantar erythrodysesthesia (PPE) associated with intravenous infusion of pegylated liposomal doxorubicin (PLD).

Methods: A retrospective review over 3 years identified 20 women who were treated with single-agent intravenous PLD for recurrent ovarian carcinoma. During PLD infusion, patients kept ice packs around their wrists and ankles, and consumed iced liquids. These steps were continued for 24 h after completion of chemotherapy. All patients were instructed not to ingest hot food or liquids, to avoid contact with hot water, and to minimize friction on the hands and feet for 72 h posttreatment.

Results: Seventeen of the twenty patients (85%) followed the regional cooling protocol, and three of twenty (15%) did not. In the group who underwent regional cooling, 16/17 (94%) had none to mild PPE (grades 0-2), and 1/17 (6%) had moderate to severe PPE (grades 3-4). Of the three patients without regional cooling, 1/3 (33%) had grades 0-2 PPE and 2/3 (67%) had grades 3-4 PPE (P = 0.047).

Conclusions: Regional cooling may reduce the frequency and severity of PPE associated with intravenous PLD infusion for recurrent ovarian carcinoma. Prospective, randomized evaluation is needed to confirm this observation.