Published online Nov 26, 2021. doi: 10.12998/wjcc.v9.i33.10075
Peer-review started: July 19, 2021
First decision: August 19, 2021
Revised: September 1, 2021
Accepted: September 22, 2021
Article in press: September 22, 2021
Published online: November 26, 2021
Pegylated liposomal doxorubicin (PLD) uses the hydrophilic layer of liposomes to reach the sweat on the skin surface or accumulate in the sweat glands, producing toxic free radicals and oxidative damage, resulting in hand-foot syndrome (HFS). Regional cooling can induce vasoconstriction to reduce the release of drugs in the limbs and reduce the accumulation of drugs in sweat glands; thus, decreasing the incidence and severity of HFS.
To study the efficacy of cooling patches to prevent HFS caused by PLD in the short-term.
This is a retrospective cohort study. Female breast cancer patients (n = 101) who were treated with PLD in two breast wards at our department from February 2020 to February 2021 were enrolled in the study and were randomly divided into the cooling group (51 patients) and the control group (50 patients). Patients in the control group only received routine care, while the patients in the cooling group applied cooling patches, based on routine care, to the palm and back of the hands 15 min before chemotherapy infusion for 10 h. All patients took a corresponding dose of dexamethasone orally one day before chemotherapy, on the day of chemotherapy, and one day after chemotherapy. SPSS23.0 version was used to analyze the data in this study. The occurrence and severity of HFS was analyzed by the Mann-Whitney U test, and scores were analyzed by the Student’s t test or Wilcoxon rank-sum test. A P value < 0.05 was regarded as statistically significant.
In this study, neither group of patients developed Grade 3 HFS. In the control group, the incidence of Grade 1 HFS and Grade 2 HFS was 38% and 2%, respectively. However, in the cooling group, only one person developed Grade 1 HFS (2%), and none of the patients developed Grade 2 HFS. These findings showed that cooling patches can effectively reduce the frequency and severity of HFS (P < 0.0001) in the short-term. Before the fourth chemotherapy cycle, although general self-efficacy scale scores in the cooling group were low, they were still significantly higher than those in the control group (17.22 ± 5.16 vs 19.63 ± 6.42, P = 0.041). Compared with the control group, the mean Hand-Foot Skin Reaction and Quality of Life Questionnaire score in the cooling group was significantly lower (18.08 ± 7.01 vs 14.20 ± 7.39, P = 0.008).
Cooling patches can effectively reduce the frequency and severity of HFS caused by PLD in the short-term. In addition, it may help delay the decline in patients’ self-efficacy.
Core Tip: The significance of cooling patches to prevent hand-foot syndrome (HFS) caused by pegylated liposomal doxorubicin (PLD) in breast cancer patients was evaluated. We retrospectively analyzed 101 breast cancer patients treated with PLD. Fifty-one patients applied cooling patches to their hands (the cooling group), and fifty patients did not apply cooling patches (the control group). We observed and recorded the occurrence of HFS. In the short-term, patients in the cooling group had a lower incidence of HFS than those in the control group (40% vs 2%), and patients' self-efficacy in the cooling group decreased more slowly than that in the control group, and the difference was statistically significant.