The Effect of Topical Heparin Gel on Reducing Hand-Foot Syndrome Symptoms in Cancer Patients Treated with Capecitabine.

Abstract

Background and aims: Hand-foot syndrome (HFS) is a distinct and relatively frequent toxic skin reaction associated with certain chemotherapy agents, particularly capecitabine. Given the complications of this syndrome and the critical importance of timely and accurate treatment, the present study aims to investigate the efficacy of topical heparin gel in alleviating HFS in cancer patients undergoing treatment with capecitabine.

Methods: A total of 40 patients with grade ⩽ 1 HFS associated with capecitabine were randomly assigned to intervention and control groups. The intervention group received heparin sulfate gel four times a day (21 days) along with capecitabine treatment, while the control group received only capecitabine and placebo gel. The changes in the severity of HFS and clinical manifestations, including erythema, swelling, blisters, hyperkeratosis, and bleeding, at baseline and 3 weeks posttreatment were evaluated. The data were subsequently validated by Fisher's or Chi-square tests.

Results: At the beginning of the study, there were no significant differences between the two groups regarding disease manifestations. However, after the intervention, a significant difference was observed between the groups in terms of erythema and swelling ( p  = 0.001). There were no significant differences between the groups in other manifestations, such as blisters, bleeding, and scaling ( p  = 0.99). Comparison of the degree of HFS in the intervention group showed that 11 patients experienced improvement after the intervention, while all patients in the control group remained at the same degree of syndrome as before the intervention.

Conclusion: The management of HFS in cancer treatment includes a combination of prevention, patient education, symptom improvement, and dose-intensity management. According to the results, it can be said that due to the positive effect of topical heparin gel in improving HFS caused by capecitabine and due to the absence of side effects, the use of topical heparin gel is recommended.

Key points: Hand-foot syndrome (HFS) is a distinct and relatively frequent toxic skin reaction associated with capecitabine.The efficacy of topical heparin gel in alleviating HFS in cancer patients was investigated.Topical heparin gel is recommended due to its positive effect in improving HFS caused by capecitabine.