Kwakman Johannes J M, Elshot Yannick S, Punt Cornelis J A, Koopman Miriam
Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam.
Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam.
Oncol Rev. 2020 May 13;14(1):442. doi: 10.4081/oncol.2020.442. eCollection 2020 Feb 18.
Improvements in systemic cancer treatments have resulted in more patients surviving for prolonged periods of time on treatment. This has made treatment-related toxicity and quality of life concerns increasingly relevant. Hand-foot syndrome (HFS) is a common skin reaction to systemic therapy that should be anticipated with chemotherapeutic treatments such as pegylated liposomal doxorubicin, docetaxel, and fluoropyrimidines. In this review we discuss current knowledge of the diagnosis, incidence, pathogenesis, and management of hand-foot syndrome (HFS). Although HFS is not life threatening, it can cause significant discomfort and impairment of function, especially in elderly patients, and may seriously impact quality of life. The incidence of HFS is dependent on the chemotherapeutic drug used, the treatment schedule, and the median duration of treatment. Effective measures for prevention and treatment of HFS include systemic and topical treatments, dose reductions, and switching to other drugs in the same class that are associated with lower rates of HFS. These approaches allow patients to continue cancer treatment while reducing negative impacts on quality of life. Awareness and early recognition are important to ensure timely treatment and avoidance of dose reductions or treatment discontinuation. We provide useful recommendations to guide the management of HFS in clinical practice.
全身癌症治疗的改善使得更多患者在接受治疗期间能够长期存活。这使得与治疗相关的毒性和生活质量问题变得越来越重要。手足综合征（HFS）是全身治疗常见的皮肤反应，在使用聚乙二醇化脂质体阿霉素、多西他赛和氟嘧啶等化疗药物时应有所预期。在本综述中，我们讨论了手足综合征（HFS）的诊断、发病率、发病机制和管理方面的现有知识。虽然HFS不会危及生命，但它会引起明显不适和功能障碍，尤其是在老年患者中，并且可能严重影响生活质量。HFS的发病率取决于所用的化疗药物、治疗方案和治疗的中位持续时间。预防和治疗HFS的有效措施包括全身和局部治疗、减少剂量以及换用同一类中与较低HFS发生率相关的其他药物。这些方法使患者能够继续癌症治疗，同时减少对生活质量的负面影响。意识和早期识别对于确保及时治疗以及避免减少剂量或中断治疗很重要。我们提供了有用的建议，以指导临床实践中HFS的管理。
