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Medline ® Abstract for Reference 118

of 'Cutaneous side effects of conventional chemotherapy agents'

118
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Prevention strategies for chemotherapy-induced hand-foot syndrome: a systematic review and meta-analysis of prospective randomised trials.
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Macedo LT, Lima JP, dos Santos LV, Sasse AD
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Support Care Cancer. 2014 Jun;22(6):1585-93. Epub 2014 Jan 26.
 
PURPOSE: Hand-foot syndrome (HSF) is a distinctive adverse event relatively frequent to some chemotherapeutic agents as capecitabine, pegylated liposomal doxorubicin, sorafenib and other tyrosine-kinase inhibitors. Since the prevention of HFS would be crucial to avoid treatment interruptions and delays, many studies have been conducted with this purpose.
METHODS: The aim of this systematic review and meta-analysis was to analyze the clinical efficacy of prevention strategies for HFS, through a wide search of electronic databases as well as congress abstracts. The endpoints evaluated were the dichotomic data for mild (Grade 1), moderate to severe (Grades 2 to 3) and all-grade HFS. Meta-analysis was calculated through RevMan v5.1 software.
RESULTS: Amongst 295 studies identified, only ten met the inclusion criteria. Celecoxib prevented both moderate to severe (odds ratio [OR]0.39, 95 % confidence interval [CI]0.20-0.73, P = 0.003) and all-grade HFS (OR 0.47, 95 % CI0.29-0.78, P = 0.003), whereas pyridoxine and topical urea/lactic acid formulations failed to prove efficacy. There were no proven benefits in mild HFS. The use of topical antiperspirant has not been shown to improve results, according to a single trial.
CONCLUSIONS: From all available possibilities for the prevention of HFS, celecoxib appears to be the most promising, with statistically significant results. Larger, multicentric studies are required to reinforce this finding.
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Clinical Oncology Division, General Hospital, State University of Campinas (UNICAMP), Vital Brasil, 251 - Cidade Universitária, 13083000, Campinas, Brazil, ligiamed@gmail.com.
PMID