Detection of free radical formation in human skin upon systemic application of chemotherapeutics.

Abstract

e20689 Background: A wide variety of chemotherapeutics is available for systemic therapy of cancers some of which, e.g., pegylated liposomal doxorubicin (PLD), paclitaxel, docetaxel, and capecetabin may induce dermal side effects (DSE). PLD is most prominent for its risk to induce palmar plantar erythrodysethesia (PPE). Recent investigations have shown that PLD escapes onto the skin surface with the sweat, and penetrates into deeper dermal layers like topically applied destroying the tissue via radical forming processes. PPE seems to be avoidable if antioxidant-containing ointments are applied previous and during therapy. To which extent this prevention strategy is feasible also for other chemotherapeutics was investigated in the presented study. Methods: The investigations were performed on 20 patients aged between 53 and 72 years who underwent their 2ndcycle of therapy with any of the aforementioned therapeutics. These volunteers exhibited no or only a mild form (grade I) of PPE at the timepoint of investigation. Using an optical skin scanner, the radical formation was indirectly measured via the decline of the antioxidant concentration immediately before and 2-4 h after the chemotherapy, respectively. Results: In about 50% of the volunteers treated with paclitaxel and in about 30% treated with capecetabin, the antioxidant concentration distinctly declined during chemotherapyThis decline was predominantly found in patients with a weak initial antioxidative protection system. Conclusions: Thus, the application of an antioxidant-containing ointment seems to be also a reasonable prevention measure for patients under therapy with other chemotherapeutics. Analyzing the antioxidant concentration with the optical skin scanner is a simple, non-invasive option to investigate any chemotherapeutic for radical forming processes in the skin during patient treatment.