Efficacy of regional cooling plus oral dexamethasone for primary prevention of hand-foot syndrome associated with pegylated liposomal doxorubicin

PurposePegylated liposomal doxorubicin (PLD)-induced hand-foot syndrome (HFS) frequently lowers the quality of life of ovarian cancer patients. Wrist and ankle cooling, having a limited preventive effect, has been the commonest supportive HFS care. In this study, we retrospectively assessed the primary preventive effect of a combination of regional cooling and oral dexamethasone therapy (cooling + oral Dex) on HFS.MethodsThis study is a single-arm retrospective, observational study. Recurrent ovarian cancer patients were administered PLD +/- bevacizumab. We retrospectively examined the efficacy of hands and feet cooling (from the start of PLD to the end) + oral Dex (day 1-5: 8 mg/day, day 6, 7: 4 mg/day) for primary HFS prevention.ResultsThis study included 74 patients. The initial dose of PLD was 50 mg/m(2) and 40 mg/m(2) for 32 (43.2%) and 42 (56.8%) patients, respectively. HFS of Grade >= 2 and Grade >= 3 developed in five (6.8%) and one (1.4%) patient(s), respectively. The incidence of >= Grade 2 and >= Grade 3 HFS was much lower than those reported in previous studies. Dose reduction was required in 13 patients (17.6%) mainly because of neutropenia or mucositis; there was no HFS-induced dose reduction. Meanwhile, PLD therapy was discontinued mainly because of interstitial pneumonia (4 patients) and HFS (one patient).ConclusionsWe demonstrated the efficacy of regional cooling and oral Dex for primary prevention of PLD-induced HFS. Although future prospective studies are needed to confirm its efficacy, this combination therapy can be considered for primary prevention of HFS in ovarian cancer patients on PLD.

Automated summary

The study aimed to retrospectively assess the primary preventive effect of a combination of regional cooling and oral dexamethasone therapy on hand-foot syndrome (HFS) induced by pegylated liposomal doxorubicin (PLD) in ovarian cancer patients. The results demonstrated the efficacy of regional cooling and oral dexamethasone therapy for primary prevention of PLD-induced HFS in ovarian cancer patients.