The use of ice chips or ice-cold water has been studied for its efficacy in the prevention of oral mucositis. Patients suck on ice or hold ice-cold water in their mouths prior to, during, and after rapid infusions of mucotoxic agents with short half-lives. Cryotherapy is based on the theory that vasoconstriction caused by cold temperatures decreases the exposure of the oral cavity mucous membranes to mucotoxic agents. Thirty minutes of oral cryotherapy is suggested for patients receiving bolus 5-fluorouracil. Cryotherapy also has been used in patients receiving high-dose melphalan. Cryotherapy is not recommended for patients who also are receiving oxaliplatin because of the associated acute temperature sensitivity, which can cause severe discomfort (Lilleby et al., 2006; Tartarone, Matera, Romano, Vigliotti, & DiRenzo, 2005).

Cryotherapy for peripheral neuropathy involves the use of frozen gloves and socks during chemotherapy administration to prevent peripheral neuropathy (Hanai et al., 2017; Griffiths et al., 2018). Cryotherapy for peripheral neuropathy is contraindicated for patients receiving oxaliplatin. 


Elad, S., Cheng, K.K.F., Lalla, R.V., Yarom, N., Hong, C., Logan, R.M., ... Zur, E. (2020). MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer, 126(19), 4423–4431. Erratum in

Griffiths, C., Kwon, N., Beaumont, J.L., & Paice, J.A. (2018). Cold therapy to prevent paclitaxel-induced peripheral neuropathy. Supportive Care in Cancer, 26, 3461–3469.  

Hanai, A., Ishiguro, H., Sozu, T., & Tsuda, M. (2018). Effects of cryotherapy on objective and subjective symptoms of paclitaxel-induced neuropathy: Prospective self-controlled trial. JNCI, 110, 141–148.

Lilleby, K., Garcia, P., Gooley, T., McDonnnell, P., Taber, R., Holmberg, L., . . . Bensinger, W. (2006). A prospective, randomized study of cryotherapy during administration of high-dose melphalan to decrease the severity and duration of oral mucositis in patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation. Bone Marrow Transplantation, 37, 1031–1035.

Tartarone, A., Matera, R., Romano, G., Vigliotti, M.L., & Di Renzo, N. (2005). Prevention of high-dose melphalan-induced mucositis by cryotherapy. Leukemia and Lymphoma, 46, 633–634.

Guideline / Expert Opinion