Prevention, Management of Hand-Foot Syndrome With Cooling Therapy

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Providing care for a patient with cancer can be a demanding job.
Providing care for a patient with cancer can be a demanding job.

Frozen gloves and socks (FGS) is a safe and tolerable management and preventive method for hand-food syndrome (HFS) among patients with ovarian cancer treated with pegylated liposomal doxorubicin (PLD), a study published in Supportive Care in Cancer has shown.

PLD is a highly effective treatment for patients with various cancers (eg, ovarian, fallopian, peritoneal) but also is associated with HFS — a specific toxicity observed with pegylated doxorubicin — greatly reducing quality of life for patients. Previous studies demonstrated the efficacy of applying ice packs around the wrist and ankles, faced challenges in preparation.

For this retrospective study, researchers evaluated the outcomes of 96 patients with advanced ovarian cancer who presented with PLD-induced or PLD+carboplatin (CBDCA)-induced HFS treated with FGS. Patients treated with PLD wore frozen gloves and socks for 15 minutes prior to and post infusion, and received new frozen gloves and socks after 45 minutes. FGS therapy was applied during all chemotherapy cycles unless refused.

Among the 96 study patients, the incidence of HFS was 51% in patients treated with PLD vs 38% in patients treated with PLD+CBDCA.

PLD dose was reduced in 41% (17) of patients in the PLD group and 9% (5) of patients in the PLD+CBDCA group, and was discontinued in 75% (31) of patients in the PLD group and 30% (17) of patients in the PLD+CBDCA group. Discontinuation of treatment was attributed to HFS in only 2 patients in the PLD group and none in the PLD+CBDCA group.

Ninety-six percent of patients completed FGS therapy; only 3 patients discontinued FGS due to associated pain from cooling.

Results of the study showed that FGS was a convenient and tolerable treatment that effectively reduced the severity and frequency of PLD-induced HFS, but concluded that “in the future, we should conduct randomized studies that include pharmacokinetic assessments to clarify the effectiveness and optimal methods of regional cooling.”


Bun S, Yunokawa M, Tamaki Y, et al. Symptom management: the utility of regional cooling for hand-food syndrome induced by pegylated liposomoal doxorubicin in ovarian cancer [published online January 25, 2018]. Support Care Cancer. doi: 10.1007/s00520-018-4054-z

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