Limb Compression Therapy and Chemotherapy-Induced Peripheral Neuropathy in Women With Gynecologic Cancers: A...

Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting toxicity of taxane-based chemotherapy with limited preventive options. We evaluated whether dual-site mechanical compression during paclitaxel infusion reduces CIPN in women with gynecologic cancers. In this prospective, intraindividual, self-controlled study, patients receiving carboplatin-paclitaxel underwent compression of the nondominant hand (two surgical gloves) and ipsilateral lower limb (Class II stocking), while contralateral limbs served as controls. CIPN was assessed using CTCAE v5.0 and EORTC QLQ-CIPN20 at baseline, Cycle 3, end of treatment (EOT), and 3- and 6-month follow-up. Among 76 patients (median age, 61 years), moderate-to-severe CIPN was observed less frequently in compression limbs than in control limbs at Cycle 3 (35.5% vs. 53.9%; p = 0.001), EOT (59.2% vs. 69.7%; p = 0.021), 3 months (28.9% vs. 52.6%; p = 0.015), and 6 months (20.3% vs. 33.8%; p = 0.002). Repeated-measures analyzes showed significant time-by-limb interactions for sensory (p = 0.003), lower-extremity sensory (p = 0.018), and motor domains (p = 0.041). Sensory CIPN20 scores were lower in compression limbs in the upper extremities from EOT onward (7.5 vs. 10.2; p < 0.001) and in the lower extremities at 3-month (8.7 vs. 10.7; p < 0.001) and 6-month follow-up (7.0 vs. 10.0; p < 0.001). EORTC QLQ-CIPN20 sensory scores identified grade ≥ 2 neuropathy with AUC values > 0.92 at all time points. Dual-site mechanical compression was associated with reduced incidence and persistence of CIPN. As a low-cost and scalable intervention, this strategy may improve treatment tolerability and survivorship outcomes. Trial Registration: ClinicalTrials.gov identifier: NCT07105553.