Clinical evaluation of the effectiveness of treatment of the hand-foot syndrome – skin toxicity of antitumor target therapy with multi-kinase inhibitors

Abstract

Background. The effective treatment of the hand-foot syndrome is a necessary component of the complex treatment of patients receiving antitumor therapy with multikinase inhibitors. Aims. The assessment of a new effective method for the treatment of palm-plantar syndrome in patients receiving multi-kinase inhibitors. Materials and methods. There are 27 patients received antitumor treatment with multi-kinase inhibitors and had clinical manifestations of the hand-foot syndrome (HFS) for observation. The main group (14 patients) used a combination of an alpha-lipoic acid at a dose of 600 mg per day per os and an ointment containing 0.005% calcipotriol and 0.05% betamethasone dipropionate 2 times a day. The control group, included 13 patients, used a combination with a cream containing 10% urea and ointment containing 0.05% betamethasone dipropionate. Results. After a week of treatment, the regression of the skin process was observed in both groups, but it was more evident in the main group: significant differences in severity of erythema, paresthesia, pain and burning sensation, the Dermatological Life Quality Index (DLQI) were observed at this stage of therapy (p 0.05). After 2 weeks of therapy: a more positive trend in the main group in terms of erythema, paresthesia and burning, but the most significant difference is DLQI 17.4 in the main group and 22.8 in the control group (p 0.0001). At the end of the 3rd week of therapy: differences with the main characteristics of erythema, desquamation, paresthesia (p 0.0008), pain (p 0.0001), DLQI (p 0.0001). At the end point of the study (after 4 weeks of therapy), significant differences were found in reducing the symptoms and the main parameters for evaluating the effectiveness of DLQI in patients of the main group with a reliability of p 0.0001. The high correlation of DLQI was found with erythema, pain, burning, paresthesia and desquamation. Conclusions. The treatment of the hand-foot plantar syndrome combined using alpha-lipoic acid inside and topical therapy in the form of an ointment containing calcipotriol and betamethasone dipropionate, can be recommended for patients receiving targeted therapy with multi-kinaseinhibitors.

Keywords

• target therapy
• multi-kinase inhibitors
• skin toxicity
• hand-foot syndrome
• palmar-plantar erythrodysesthesia
• alpha-lipoic (tioctic) acid
• calcipotriol
• betamethasone