Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
Support Care Cancer. 2013 Mar;21(3):907-11. doi: 10.1007/s00520-012-1693-3. Epub 2012 Dec 21.
The purpose of this study is to evaluate the efficacy of a protocol including topical heparin therapy for hand-foot skin reactions (HFSR) during multikinase (MKI) treatment.
We prospectively collected 26 patients who had HFSRs during treatment with the MKIs, sunitinib, sorafenib, or axitinib. The age distribution ranged from 46 to 87 years, with a mean of 66 years. The distribution of HFSR severity was 12 patients with grade 1, 12 with grade 2, and 2 with grade 3. A heparin-containing topical ointment treatment, combined with hand-foot shock absorbers and skin moisturizers, was used at the lesion sites. Changes in the grade of HFSR, MKI dosage, and interruptions of MKI therapy were recorded.
The results showed that 66.7% of grade 1 patients were cured of disease, 83.3% of grade 2 patients had improved symptoms, and both grade 3 patients (100%) had improved symptoms and were downgraded to grade 2. Four (15.4%) patients required reduction of MKI dosage, but there were no treatment interruptions or dropouts.
Our protocol is beneficial in promoting resolution of HFSRs induced by MKIs. Further validation in large control studies should be investigated.
本研究旨在评估一种包括局部肝素治疗方案在手足皮肤反应（HFSR）在多激酶（MKI）治疗中的疗效。
我们前瞻性地收集了 26 名在使用 MKIs、舒尼替尼、索拉非尼或阿昔替尼治疗时出现 HFSR 的患者。年龄分布范围为 46 岁至 87 岁，平均 66 岁。HFSR 严重程度的分布为 12 例 1 级、12 例 2 级和 2 例 3 级。在病变部位使用含有肝素的局部软膏治疗，并结合手足减震器和皮肤保湿剂。记录 HFSR 分级、MKI 剂量和 MKI 治疗中断的变化。
结果显示，66.7%的 1 级患者疾病痊愈，83.3%的 2 级患者症状改善，2 例 3 级患者（100%）症状改善且降级为 2 级。4 例（15.4%）患者需要减少 MKI 剂量，但没有治疗中断或退出。
我们的方案有利于促进 MKI 引起的 HFSR 的消退。应进一步在大型对照研究中进行验证。
