Cryopreventive temperatures prior to chemotherapy

Abstract

Abstract Background: The superiority of oral cryotherapy (OC) for prevention of chemotherapy-induced oral mucositis (OM) has been demonstrated in several trials. In clinical settings, cooling is usually initiated prior to the chemotherapy infusion. It then continues during the infusion, and for a period after the infusion has been completed. While the cooling period post-infusion depends on the half-life of the chemotherapeutic drug, there is no consensus on when cooling should be initiated prior to the infusion. The lowest achieved temperature in the oral mucosa is believed to provide the best conditions to prevent OM. Given this, it was of interest to investigate when along the course of intraoral cooling this temperature is achieved. Subjects and method: In total, 20 healthy volunteers participated in this randomized crossover trial. Each subject attended three separate cooling sessions of 30 minutes each, with ice chips (IC) and the intraoral cooling device (ICD) set to 8°C and 15°C, respectively. At baseline and following 5, 10, 15, 20 and 30 minutes of cooling, intraoral temperatures were registered using a thermographic camera. Results: The greatest drop in intraoral temperature was seen after 5 minutes of cooling with both IC, ICD8°C and ICD15°C, respectively. A statistically significant difference, corresponding to 1.4°C was seen between IC and the ICD15°C (p < 0.05). The intraoral temperature further declined throughout the 30 minutes of cooling, showing an additional temperature reduction of 3.1°C, 2.2°C, and 1.7°C for IC, ICD8°C and ICD15°C, respectively. Conclusion: The greatest drop in intraoral temperature is seen following 5 minutes of cooling.